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Home
About
Contact
Calendar
Business Services
Job Seekers
CHA Job Seekers
CHA Families
Workforce Solutions Program

Intake Formadmin2026-01-09T05:46:12-06:00

Ready to find the help you need?

Please complete this form and then choose the path to connect with a workforce professional ready to help you

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Choose your path:

Are you interested in finding a career today and working with a dedicated Career Coach?

Are you working with a training school and want to apply for a Training Voucher?

Are you a CHA Resident looking for employment?

Are you searching for a job but have barriers that make it difficult?

I agree that by submitting this form, I consent to receive communications from E&ES via SMS, phone calls, and email regarding my WIOA application, eligibility, required documents, appointments, and program updates. I understand that message and data rates may apply and that I may opt out of communications at any time.

You must agree before continuing.

Last 4 of Social Security Number *

Are you 18 Years or Older? *

Yes

Are you currently employed? *

Yes

Client ID (If you know it):

Date of Birth:

What type of work are you interested in?

Retail

Security

Health Care

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Other

How can we best help you? (Please select from the drop-down menu)*

Is there any other information you would like to share with us about your career goals?

How did you hear about us?

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Text

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Other

Last four digits of your Social Security *

Are you being referred by a Training School, Apprenticeship, or Employer?

Are you authorized to work in the USA? *

Do you have barriers preventing you from gaining employment?

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