Name
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First Name
Last Name
Email
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Phone
(###)
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Date of Birth
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Current Address or Reentry Housing Location
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Emergency Contact (Name & Phone Number)
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Reentry & Support System Date of Release or Expected Release Date
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Facility Released From
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Are you currently in a reentry or transitional housing program? Yes / No
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If yes, name of program & location
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Contact person (Case Manager/Coordinator) & phone number
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How long do you plan to stay in the program?
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Do you have a case manager or reentry specialist? Yes / No
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If yes, name & contact information
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Are you currently on probation or parole? Yes / No
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If yes, name of officer & contact information
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Have you completed or are you participating in any rehabilitation, recovery, or job-readiness programs? Yes / No
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If yes, name of program
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Contact person & phone number
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Have you ever been required to participate in a drug or alcohol recovery program? Yes / No
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Have you ever been drug tested as part of probation or parole? Yes / No
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Are you currently drug tested by any agency or program? Yes / No
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No prior experience in the trades is required to apply. Have you previously worked in a trade or skilled labor position? Yes / No
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If yes, what trade(s) and for how long?
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Do you have any experience with carpentry, construction, or similar work? Yes / No
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If yes, describe
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What are your employment goals after completing this program?
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Find full-time employment in the trades
Begin an apprenticeship
Further my education in a trade school
Other (please specify):
Do you have any physical limitations that might affect your ability to perform construction work? Yes / No
If yes, please explain
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Do you have a valid driver’s license? Yes / No
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Do you have access to reliable transportation? Yes / No
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Do you have any pending legal matters? Yes / No
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If yes, please explain. Pending legal issues do NOT automatically disqualify you from the program.
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Are you able to commit to a 12-week training program? Yes / No
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Are you available one evening per week for a three-hour class? Yes / No
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Are you available during the day on Saturdays? Yes / No
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Are you willing to follow all program rules, including maintaining strict sobriety for the duration of the program, regardless of your personal history with substance use? This includes abstaining from alcohol and drugs at all times, on-site and off-site, and complying with any testing policies. Yes / No
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Why do you want to join the Skilled Purpose program? Briefly explain in 2-3 sentences.
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Is there anything else you’d like us to know about you or your situation?
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Please provide at least one reference who can speak to your commitment to reentry and employment readiness. This could be a case manager, employer, mentor, or another trusted individual. Please include name, phone number, and your relationship.
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If you are selected to move forward in the application process, you will be required to submit a CORI (Criminal Offender Record Information) report for review before final acceptance into the program. Instructions will be provided if this applies to you. Please note: Individuals with convictions for sex offenses or crimes involving violence against women or children will not be accepted into the Skilled Purpose program. This policy is in place to protect the safety and integrity of our participants and program community. Signature & Acknowledgment I certify that the information provided in this application is true to the best of my knowledge. I understand that acceptance into the Skilled Purpose program is contingent upon meeting eligibility requirements and agreeing to all program rules. Applicant signature and date required below.
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