www.alexanderjfs.org
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34.251.201.224
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Submitted URL: https://r20.rs6.net/tn.jsp?f=001OPaUx--zOXMqUaS8iULjr87gyCnsNNcFe-LVk3VdCaSEB6lJSNa_wo3V8LbFcz3f2eVfuJCcpYTu7WmlhMb9...
Effective URL: https://www.alexanderjfs.org/forms/employment-services-intake-form
Submission: On May 02 via api from US — Scanned from DE
Effective URL: https://www.alexanderjfs.org/forms/employment-services-intake-form
Submission: On May 02 via api from US — Scanned from DE
Form analysis 4 forms found in the DOM
/search
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<div class="img-search"></div><input type="search" spellcheck="false" class="search-input w-input" maxlength="256" name="query" aria-label="search" placeholder="Search…" id="search-nav" input-type="search" required=""><input type="submit"
value="Search" class="search-button w-button">
</form>/search
<form action="/search" id="search" aria-label="search" class="search w-form">
<div class="img-search"></div><input type="search" class="search-input w-input" maxlength="256" name="query" placeholder="" id="search" required=""><input type="submit" value="Search" class="search-button w-button">
</form>POST https://jewishfamilyservicesajivu.formstack.com/forms/index.php
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<div id="resumeConfirmPassword" style="display: none;">Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.</div>
<div id="saveAndResume" style="display: none;">Save and Resume Later</div>
<div id="saveResumeProcess" style="display: none;">Save and get link</div>
<div id="fileTypeAlert" style="display:none;">You must upload one of the following file types for the selected field:</div>
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<div id="applyDiscountButton" style="display:none;">Apply Discount</div>
<div id="dcmYouSaved" style="display:none;">You saved</div>
<div id="dcmWithCode" style="display:none;">with code</div>
<div id="submitButtonText" style="display:none;">Submit Form</div>
<div id="submittingText" style="display:none;">Submitting</div>
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<div id="checkFieldPrompt" style="display:none;">Please check the field: </div>
<div id="translatedWord-fields" style="display:none;">Fields</div>
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<p><span style="font-size: 24px;">Alexander JFS Career and Employment Services Intake Form</span></p>
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aria-required="true">Native Hawaiian or Other Pacific Islander</label>
<label class="fsOptionLabel vertical" for="field101726799_8"><input type="radio" id="field101726799_8" name="field101726799" value="White" class="fsField fsRequired vertical" aria-required="true">White</label>
<label class="fsOptionLabel vertical" for="field101726799_9"><input type="radio" id="field101726799_9" name="field101726799" value="Not listed" class="fsField fsRequired vertical" aria-required="true">Not listed</label>
<label class="fsOptionLabel vertical" for="field101726799_10"><input type="radio" id="field101726799_10" name="field101726799" value="Unknown" class="fsField fsRequired vertical" aria-required="true">Unknown</label>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-10" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101726829" lang="en" fs-field-type="text" fs-field-validation-name="Religion ">
<label id="label101726829" class="fsLabel" for="field101726829">Religion </label>
<input type="text" id="field101726829" name="field101726829" size="50" value="" class="fsField fsFormatText ">
</div>
</div>
<div id="fsRow4136659-11" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101726835" lang="en" fs-field-type="radio" fs-field-validation-name="Sex">
<fieldset role="group" aria-labelledby="fsLegend101726835" id="label101726835">
<legend id="fsLegend101726835" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Sex<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field101726835_1"><input type="radio" id="field101726835_1" name="field101726835" value="Female" class="fsField fsRequired vertical" aria-required="true">Female</label>
<label class="fsOptionLabel vertical" for="field101726835_2"><input type="radio" id="field101726835_2" name="field101726835" value="Male" class="fsField fsRequired vertical" aria-required="true">Male</label>
<div class="vertical fs-clear">
<label class="fsOptionLabel vertical" for="field101726835_other"><input type="radio" id="field101726835_other" name="field101726835" value="Other" class="fsField fsRequired" aria-required="true">Other:</label>
<input type="text" id="field101726835_othervalue" name="field101726835_other" size="15" class="fsOtherField" aria-required="true"><label class="fsHiddenLabel" style="display: none;" for="field101726835_othervalue">Other Value</label>
</div>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-12" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell122806441" lang="en" fs-field-type="radio" fs-field-validation-name="Gender Identity">
<fieldset role="group" aria-labelledby="fsLegend122806441" id="label122806441">
<legend id="fsLegend122806441" class="fsLabel fsLabelVertical"><span>Gender Identity</span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field122806441_1"><input type="radio" id="field122806441_1" name="field122806441" value="Female" class="fsField vertical">Female</label>
<label class="fsOptionLabel vertical" for="field122806441_2"><input type="radio" id="field122806441_2" name="field122806441" value="Male" class="fsField vertical">Male</label>
<label class="fsOptionLabel vertical" for="field122806441_3"><input type="radio" id="field122806441_3" name="field122806441" value="Non-binary (non-conforming)" class="fsField vertical">Non-binary (non-conforming)</label>
<label class="fsOptionLabel vertical" for="field122806441_4"><input type="radio" id="field122806441_4" name="field122806441" value="Transgender Female" class="fsField vertical">Transgender Female</label>
<label class="fsOptionLabel vertical" for="field122806441_5"><input type="radio" id="field122806441_5" name="field122806441" value="Transgender Male" class="fsField vertical">Transgender Male</label>
<label class="fsOptionLabel vertical" for="field122806441_6"><input type="radio" id="field122806441_6" name="field122806441" value="Not listed/other" class="fsField vertical">Not listed/other</label>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-13" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101726876" lang="en" fs-field-type="radio" fs-field-validation-name="Personal Gender Pronouns">
<fieldset role="group" aria-labelledby="fsLegend101726876" id="label101726876">
<legend id="fsLegend101726876" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Personal Gender Pronouns<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field101726876_1"><input type="radio" id="field101726876_1" name="field101726876" value="He/Him/His" class="fsField fsRequired vertical" aria-required="true">He/Him/His</label>
<label class="fsOptionLabel vertical" for="field101726876_2"><input type="radio" id="field101726876_2" name="field101726876" value="She/Her/Hers" class="fsField fsRequired vertical" aria-required="true">She/Her/Hers</label>
<label class="fsOptionLabel vertical" for="field101726876_3"><input type="radio" id="field101726876_3" name="field101726876" value="They/Them/Theirs" class="fsField fsRequired vertical" aria-required="true">They/Them/Theirs</label>
<div class="vertical fs-clear">
<label class="fsOptionLabel vertical" for="field101726876_other"><input type="radio" id="field101726876_other" name="field101726876" value="Other" class="fsField fsRequired" aria-required="true">Other:</label>
<input type="text" id="field101726876_othervalue" name="field101726876_other" size="15" class="fsOtherField" aria-required="true"><label class="fsHiddenLabel" style="display: none;" for="field101726876_othervalue">Other Value</label>
</div>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-14" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101726922" lang="en" fs-field-type="text" fs-field-validation-name="Primary language: ">
<label id="label101726922" class="fsLabel" for="field101726922">Primary language: </label>
<input type="text" id="field101726922" name="field101726922" size="50" value="" class="fsField fsFormatText ">
</div>
</div>
<div id="fsRow4136659-15" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108691408" lang="en" fs-field-type="radio" fs-field-validation-name="Highest Level of Education. Single choice">
<fieldset role="group" aria-labelledby="fsLegend108691408" id="label108691408">
<legend id="fsLegend108691408" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Highest Level of Education. Single choice<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field108691408_1"><input type="radio" id="field108691408_1" name="field108691408" value="High School/GED" class="fsField fsRequired vertical" aria-required="true">High School/GED</label>
<label class="fsOptionLabel vertical" for="field108691408_2"><input type="radio" id="field108691408_2" name="field108691408" value="Some College" class="fsField fsRequired vertical" aria-required="true">Some College</label>
<label class="fsOptionLabel vertical" for="field108691408_3"><input type="radio" id="field108691408_3" name="field108691408" value="Vocational Certification: VAST Academy or other program" class="fsField fsRequired vertical"
aria-required="true">Vocational Certification: VAST Academy or other program</label>
<label class="fsOptionLabel vertical" for="field108691408_4"><input type="radio" id="field108691408_4" name="field108691408" value="Technical Certification" class="fsField fsRequired vertical" aria-required="true">Technical
Certification</label>
<label class="fsOptionLabel vertical" for="field108691408_5"><input type="radio" id="field108691408_5" name="field108691408" value="Associates Degree" class="fsField fsRequired vertical" aria-required="true">Associates Degree</label>
<label class="fsOptionLabel vertical" for="field108691408_6"><input type="radio" id="field108691408_6" name="field108691408" value="Bachelor Degree" class="fsField fsRequired vertical" aria-required="true">Bachelor Degree</label>
<label class="fsOptionLabel vertical" for="field108691408_7"><input type="radio" id="field108691408_7" name="field108691408" value="Master Degree" class="fsField fsRequired vertical" aria-required="true">Master Degree</label>
<label class="fsOptionLabel vertical" for="field108691408_8"><input type="radio" id="field108691408_8" name="field108691408" value="Ph.D" class="fsField fsRequired vertical" aria-required="true">Ph.D</label>
<label class="fsOptionLabel vertical" for="field108691408_9"><input type="radio" id="field108691408_9" name="field108691408" value="Professional Degree - JD" class="fsField fsRequired vertical" aria-required="true">Professional Degree -
JD</label>
<label class="fsOptionLabel vertical" for="field108691408_10"><input type="radio" id="field108691408_10" name="field108691408" value="Professional Degree - MD" class="fsField fsRequired vertical" aria-required="true">Professional Degree
- MD</label>
<div class="vertical fs-clear">
<label class="fsOptionLabel vertical" for="field108691408_other"><input type="radio" id="field108691408_other" name="field108691408" value="Other" class="fsField fsRequired" aria-required="true">Other:</label>
<input type="text" id="field108691408_othervalue" name="field108691408_other" size="15" class="fsOtherField" aria-required="true"><label class="fsHiddenLabel" style="display: none;" for="field108691408_othervalue">Other Value</label>
</div>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-16" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108692077" lang="en" fs-field-type="text"
fs-field-validation-name="Occupation - Please enter either your most recent job title or the job title you want to have.">
<label id="label108692077" class="fsLabel fsRequiredLabel" for="field108692077">Occupation - Please enter either your most recent job title or the job title you want to have.<span class="fsRequiredMarker">*</span> </label>
<input type="text" id="field108692077" name="field108692077" size="50" required="" value="" class="fsField fsFormatText fsRequired " aria-required="true">
</div>
</div>
<div id="fsRow4136659-17" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101727048" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<p><span style="font-size: 24px;">Financial Information </span></p>
<p><br></p>
<p>We collect financial information to determine the fee which is based on a sliding scale. It is determined by your household income and number of people living in your household.</p>
</div>
</div>
<div id="fsRow4136659-18" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell113298864" lang="en" fs-field-type="number" fs-field-validation-name="Monthly Income">
<label id="label113298864" class="fsLabel fsRequiredLabel" for="field113298864">Monthly Income<span class="fsRequiredMarker">*</span> </label>
<input type="number" step="any" id="field113298864" name="field113298864" required="" class="fsField fsFormatNumber fsNumberDecimals-0 fsRequired" aria-required="true">
<script>
//This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields.
//Normal attempts to restrict the comma such as our own validation or .replace(",", "") results in the value of the field being removed entirely.
//Below the keypress itself is being blocked as a workaround to keep our value.
document.getElementById("field113298864").addEventListener("keydown", function blockComma(e) {
if (e.code === 'Comma') {
e.preventDefault();
}
})
</script>
</div>
</div>
<div id="fsRow4136659-19" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101727071" lang="en" fs-field-type="number" fs-field-validation-name="Number of people living in your household (include all adults and children)">
<label id="label101727071" class="fsLabel fsRequiredLabel" for="field101727071">Number of people living in your household (include all adults and children)<span class="fsRequiredMarker">*</span> </label>
<input type="number" step="any" id="field101727071" name="field101727071" required="" class="fsField fsFormatNumber fsNumberDecimals-0 fsRequired" aria-required="true">
<script>
//This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields.
//Normal attempts to restrict the comma such as our own validation or .replace(",", "") results in the value of the field being removed entirely.
//Below the keypress itself is being blocked as a workaround to keep our value.
document.getElementById("field101727071").addEventListener("keydown", function blockComma(e) {
if (e.code === 'Comma') {
e.preventDefault();
}
})
</script>
</div>
</div>
<div id="fsRow4136659-20" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108711680" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<p><span style="font-size: 24px;">Job Readiness Questions</span></p>
<p>This section will help us determine your job search needs.</p>
<p><br></p>
</div>
</div>
<div id="fsRow4136659-21" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101727455" lang="en" fs-field-type="matrix" fs-field-validation-name="Job Readiness Questions">
<fieldset id="matrix-field101727455-fieldset" aria-labelledby="fsLegend101727455" role="group" class="fsMatrixFieldset">
<legend id="fsLegend101727455" class="fsLabel fsLabelVertical"><span>Job Readiness Questions</span></legend>
<table id="matrix-field101727455" class="fsMatrix">
<caption style="height: 0;width: 0;overflow: hidden">Job Readiness Questions</caption>
<tbody>
<tr>
<th scope="col" class="fsMatrixColCount4"> </th>
<th scope="col" class="fsMatrixLabel fsMatrixLabelColumn fsMatrixCol1 fsMatrixColCount4">Yes</th>
<th scope="col" class="fsMatrixLabel fsMatrixLabelColumn fsMatrixCol2 fsMatrixColCount4">No</th>
<th scope="col" class="fsMatrixLabel fsMatrixLabelColumn fsMatrixCol1 fsMatrixColCount4">I do not know</th>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I know the qualifications for jobs I am applying.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-1-1">Job Readiness Questions: I know the qualifications for jobs I am applying. (Yes)</label>
<input type="radio" id="field101727455-1-1" name="field101727455-1" value="I know the qualifications for jobs I am applying. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-1-2">I know the qualifications for jobs I am applying. (No)</label>
<input type="radio" id="field101727455-1-2" name="field101727455-1" value="I know the qualifications for jobs I am applying. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-1-3">I know the qualifications for jobs I am applying. (I do not know)</label>
<input type="radio" id="field101727455-1-3" name="field101727455-1" value="I know the qualifications for jobs I am applying. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have a job search plan with timelines.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-2-1">I have a job search plan with timelines. (Yes)</label>
<input type="radio" id="field101727455-2-1" name="field101727455-2" value="I have a job search plan with timelines. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-2-2">I have a job search plan with timelines. (No)</label>
<input type="radio" id="field101727455-2-2" name="field101727455-2" value="I have a job search plan with timelines. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-2-3">I have a job search plan with timelines. (I do not know)</label>
<input type="radio" id="field101727455-2-3" name="field101727455-2" value="I have a job search plan with timelines. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I can write a cover letter.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-3-1">I can write a cover letter. (Yes)</label>
<input type="radio" id="field101727455-3-1" name="field101727455-3" value="I can write a cover letter. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-3-2">I can write a cover letter. (No)</label>
<input type="radio" id="field101727455-3-2" name="field101727455-3" value="I can write a cover letter. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-3-3">I can write a cover letter. (I do not know)</label>
<input type="radio" id="field101727455-3-3" name="field101727455-3" value="I can write a cover letter. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have a networking list.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-4-1">I have a networking list. (Yes)</label>
<input type="radio" id="field101727455-4-1" name="field101727455-4" value="I have a networking list. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-4-2">I have a networking list. (No)</label>
<input type="radio" id="field101727455-4-2" name="field101727455-4" value="I have a networking list. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-4-3">I have a networking list. (I do not know)</label>
<input type="radio" id="field101727455-4-3" name="field101727455-4" value="I have a networking list. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have had a mock interview.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-5-1">I have had a mock interview. (Yes)</label>
<input type="radio" id="field101727455-5-1" name="field101727455-5" value="I have had a mock interview. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-5-2">I have had a mock interview. (No)</label>
<input type="radio" id="field101727455-5-2" name="field101727455-5" value="I have had a mock interview. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-5-3">I have had a mock interview. (I do not know)</label>
<input type="radio" id="field101727455-5-3" name="field101727455-5" value="I have had a mock interview. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have a LinkedIn account.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-6-1">I have a LinkedIn account. (Yes)</label>
<input type="radio" id="field101727455-6-1" name="field101727455-6" value="I have a LinkedIn account. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-6-2">I have a LinkedIn account. (No)</label>
<input type="radio" id="field101727455-6-2" name="field101727455-6" value="I have a LinkedIn account. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-6-3">I have a LinkedIn account. (I do not know)</label>
<input type="radio" id="field101727455-6-3" name="field101727455-6" value="I have a LinkedIn account. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have a Work in Texas profile.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-7-1">I have a Work in Texas profile. (Yes)</label>
<input type="radio" id="field101727455-7-1" name="field101727455-7" value="I have a Work in Texas profile. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-7-2">I have a Work in Texas profile. (No)</label>
<input type="radio" id="field101727455-7-2" name="field101727455-7" value="I have a Work in Texas profile. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-7-3">I have a Work in Texas profile. (I do not know)</label>
<input type="radio" id="field101727455-7-3" name="field101727455-7" value="I have a Work in Texas profile. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have had at least one face to face networking meeting.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-8-1">I have had at least one face to face networking meeting. (Yes)</label>
<input type="radio" id="field101727455-8-1" name="field101727455-8" value="I have had at least one face to face networking meeting. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-8-2">I have had at least one face to face networking meeting. (No)</label>
<input type="radio" id="field101727455-8-2" name="field101727455-8" value="I have had at least one face to face networking meeting. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-8-3">I have had at least one face to face networking meeting. (I do not know)</label>
<input type="radio" id="field101727455-8-3" name="field101727455-8" value="I have had at least one face to face networking meeting. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I can complete a job application online.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-9-1">I can complete a job application online. (Yes)</label>
<input type="radio" id="field101727455-9-1" name="field101727455-9" value="I can complete a job application online. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-9-2">I can complete a job application online. (No)</label>
<input type="radio" id="field101727455-9-2" name="field101727455-9" value="I can complete a job application online. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-9-3">I can complete a job application online. (I do not know)</label>
<input type="radio" id="field101727455-9-3" name="field101727455-9" value="I can complete a job application online. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have prepared answers for questions during an interview.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-10-1">I have prepared answers for questions during an interview. (Yes)</label>
<input type="radio" id="field101727455-10-1" name="field101727455-10" value="I have prepared answers for questions during an interview. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-10-2">I have prepared answers for questions during an interview. (No)</label>
<input type="radio" id="field101727455-10-2" name="field101727455-10" value="I have prepared answers for questions during an interview. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-10-3">I have prepared answers for questions during an interview. (I do not know)</label>
<input type="radio" id="field101727455-10-3" name="field101727455-10" value="I have prepared answers for questions during an interview. = I do not know" class="fsField">
</td>
</tr>
<tr>
<th class="fsMatrixLabel fsMatrixLabelRow" scope="row">I have access to a computer to complete my job search.</th>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-11-1">I have access to a computer to complete my job search. (Yes)</label>
<input type="radio" id="field101727455-11-1" name="field101727455-11" value="I have access to a computer to complete my job search. = Yes" class="fsField">
</td>
<td class="fsMatrixCol2 fsMatrixColCount4">
<label class="hidden" for="field101727455-11-2">I have access to a computer to complete my job search. (No)</label>
<input type="radio" id="field101727455-11-2" name="field101727455-11" value="I have access to a computer to complete my job search. = No" class="fsField">
</td>
<td class="fsMatrixCol1 fsMatrixColCount4">
<label class="hidden" for="field101727455-11-3">I have access to a computer to complete my job search. (I do not know)</label>
<input type="radio" id="field101727455-11-3" name="field101727455-11" value="I have access to a computer to complete my job search. = I do not know" class="fsField">
</td>
</tr>
</tbody>
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<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108708357" lang="en" fs-field-type="checkbox" fs-field-validation-name="Do you have a disability? Check all that apply.">
<fieldset role="group" aria-labelledby="fsLegend108708357" id="label108708357">
<legend id="fsLegend108708357" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Do you have a disability? Check all that apply.<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field108708357_1"><input type="checkbox" id="field108708357_1" name="field108708357[]" value="None" class="fsField fsRequired vertical" aria-required="true">None</label>
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<label class="fsOptionLabel vertical" for="field108708357_3"><input type="checkbox" id="field108708357_3" name="field108708357[]" value="Walking" class="fsField fsRequired vertical" aria-required="true">Walking</label>
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<label class="fsOptionLabel vertical" for="field108708357_6"><input type="checkbox" id="field108708357_6" name="field108708357[]" value="Making decisions" class="fsField fsRequired vertical" aria-required="true">Making decisions</label>
<label class="fsOptionLabel vertical" for="field108708357_7"><input type="checkbox" id="field108708357_7" name="field108708357[]" value="Visiting a doctor alone or running errands" class="fsField fsRequired vertical"
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<label class="fsOptionLabel vertical" for="field108708357_8"><input type="checkbox" id="field108708357_8" name="field108708357[]" value="Physical condition" class="fsField fsRequired vertical" aria-required="true">Physical
condition</label>
<label class="fsOptionLabel vertical" for="field108708357_9"><input type="checkbox" id="field108708357_9" name="field108708357[]" value="Intellectual or Developmental Condition" class="fsField fsRequired vertical"
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</fieldset>
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</div>
<div id="fsRow4136659-23" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101727654" lang="en" fs-field-type="radio"
fs-field-validation-name="Are you a customer of Texas Workforce Commission, Vocational Rehabilitation department (formerly DARS)?">
<fieldset role="group" aria-labelledby="fsLegend101727654" id="label101727654">
<legend id="fsLegend101727654" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Are you a customer of Texas Workforce Commission, Vocational Rehabilitation department (formerly DARS)?<span class="fsRequiredMarker">*</span></span>
</legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field101727654_1"><input type="radio" id="field101727654_1" name="field101727654" value="Yes" class="fsField fsRequired vertical" aria-required="true">Yes</label>
<label class="fsOptionLabel vertical" for="field101727654_2"><input type="radio" id="field101727654_2" name="field101727654" value="No" class="fsField fsRequired vertical" aria-required="true">No</label>
<label class="fsOptionLabel vertical" for="field101727654_3"><input type="radio" id="field101727654_3" name="field101727654" value="Maybe" class="fsField fsRequired vertical" aria-required="true">Maybe</label>
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</fieldset>
</div>
</div>
<div id="fsRow4136659-24" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell101727673" lang="en" fs-field-type="text" fs-field-validation-name="Name of Counselor">
<label id="label101727673" class="fsLabel fsRequiredLabel" for="field101727673">Name of Counselor<span class="fsRequiredMarker">*</span> </label>
<input type="text" id="field101727673" name="field101727673" size="50" required="" value="" class="fsField fsFormatText fsRequired " aria-required="true" disabled="disabled">
</div>
</div>
<div id="fsRow4136659-25" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell128289636" lang="en" fs-field-type="radio" fs-field-validation-name="Are you legally authorized to work in the United States?">
<fieldset role="group" aria-labelledby="fsLegend128289636" id="label128289636">
<legend id="fsLegend128289636" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Are you legally authorized to work in the United States?<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field128289636_1"><input type="radio" id="field128289636_1" name="field128289636" value="Yes" class="fsField fsRequired vertical" aria-required="true">Yes</label>
<label class="fsOptionLabel vertical" for="field128289636_2"><input type="radio" id="field128289636_2" name="field128289636" value="No" class="fsField fsRequired vertical" aria-required="true">No</label>
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</fieldset>
</div>
</div>
<div id="fsRow4136659-26" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell128290553" lang="en" fs-field-type="radio" fs-field-validation-name="">
<fieldset role="group" aria-labelledby="fsLegend128290553" id="label128290553">
<legend id="fsLegend128290553" class="fsLabel fsRequiredLabel fsLabelVertical"><span><span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field128290553_1"><input type="radio" id="field128290553_1" name="field128290553" value="Do you have a green card?" class="fsField fsRequired vertical" aria-required="true"
disabled="disabled">Do you have a green card?</label>
<label class="fsOptionLabel vertical" for="field128290553_2"><input type="radio" id="field128290553_2" name="field128290553" value="Do you have a work permit?" class="fsField fsRequired vertical" aria-required="true"
disabled="disabled">Do you have a work permit?</label>
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</fieldset>
</div>
</div>
<div id="fsRow4136659-27" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108708819" lang="en" fs-field-type="textarea" fs-field-validation-name="What job would you like to have?">
<label id="label108708819" class="fsLabel fsRequiredLabel" for="field108708819">What job would you like to have?<span class="fsRequiredMarker">*</span> </label>
<textarea id="field108708819" class="fsField fsRequired " name="field108708819" rows="10" cols="50" required="" aria-required="true"></textarea>
</div>
</div>
<div id="fsRow4136659-28" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108708834" lang="en" fs-field-type="checkbox" fs-field-validation-name="I have been out of work for:">
<fieldset role="group" aria-labelledby="fsLegend108708834" id="label108708834">
<legend id="fsLegend108708834" class="fsLabel fsRequiredLabel fsLabelVertical"><span>I have been out of work for:<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field108708834_1"><input type="checkbox" id="field108708834_1" name="field108708834[]" value="Less than 1 year" class="fsField fsRequired vertical" aria-required="true">Less than 1 year</label>
<label class="fsOptionLabel vertical" for="field108708834_2"><input type="checkbox" id="field108708834_2" name="field108708834[]" value="1 - 2 years" class="fsField fsRequired vertical" aria-required="true">1 - 2 years</label>
<label class="fsOptionLabel vertical" for="field108708834_3"><input type="checkbox" id="field108708834_3" name="field108708834[]" value="3 plus years" class="fsField fsRequired vertical" aria-required="true">3 plus years</label>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-29" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108708868" lang="en" fs-field-type="checkbox" fs-field-validation-name="I need further training on: Select all that apply">
<fieldset role="group" aria-labelledby="fsLegend108708868" id="label108708868">
<legend id="fsLegend108708868" class="fsLabel fsRequiredLabel fsLabelVertical"><span>I need further training on: Select all that apply<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field108708868_1"><input type="checkbox" id="field108708868_1" name="field108708868[]" value="Completing a job application" class="fsField fsRequired vertical" aria-required="true">Completing a
job application</label>
<label class="fsOptionLabel vertical" for="field108708868_2"><input type="checkbox" id="field108708868_2" name="field108708868[]" value="Effective resumes and cover letters" class="fsField fsRequired vertical"
aria-required="true">Effective resumes and cover letters</label>
<label class="fsOptionLabel vertical" for="field108708868_3"><input type="checkbox" id="field108708868_3" name="field108708868[]" value="Interviewing techniques" class="fsField fsRequired vertical" aria-required="true">Interviewing
techniques</label>
<label class="fsOptionLabel vertical" for="field108708868_4"><input type="checkbox" id="field108708868_4" name="field108708868[]" value="Job search readiness" class="fsField fsRequired vertical" aria-required="true">Job search
readiness</label>
<label class="fsOptionLabel vertical" for="field108708868_5"><input type="checkbox" id="field108708868_5" name="field108708868[]" value="Networking strategies" class="fsField fsRequired vertical" aria-required="true">Networking
strategies</label>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-30" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell110515534" lang="en" fs-field-type="radio" fs-field-validation-name="Do you have a resume?">
<fieldset role="group" aria-labelledby="fsLegend110515534" id="label110515534">
<legend id="fsLegend110515534" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Do you have a resume?<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field110515534_1"><input type="radio" id="field110515534_1" name="field110515534" value="Yes" class="fsField fsRequired vertical" aria-required="true">Yes</label>
<label class="fsOptionLabel vertical" for="field110515534_2"><input type="radio" id="field110515534_2" name="field110515534" value="No" class="fsField fsRequired vertical" aria-required="true">No</label>
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</fieldset>
</div>
</div>
<div id="fsRow4136659-31" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell110515952" lang="en" fs-field-type="file" fs-field-validation-name="Upload most current resume">
<fieldset role="group" aria-labelledby="fsLegend110515952" id="label110515952">
<legend id="fsLegend110515952" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Upload most current resume<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<input type="file" style="display: none" id="field110515952" name="field110515952" size="30" required="" aria-required="true"
class="fsField fsUpload uploadTypes-jpg,jpeg,gif,png,bmp,tif,psd,pdf,doc,docx,csv,xls,xlsx,txt,mp3,mp4,aac,wav,au,wmv,avi,mpg,mpeg,zip,gz,rar,z,tgz,tar,sitx fsRequired" disabled="disabled">
<input type="button" class="fsFileUploadButton" id="field110515952UploadButton" aria-controls="field110515952" value="Choose File" disabled="">
<input type="button" class="fsFileUploadButton" id="field110515952DeleteButton" aria-controls="field110515952" value="Remove File" disabled="">
<span class="fsFileUploadName" id="field110515952FileName">No File Chosen</span>
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</fieldset>
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</div>
<div id="fsRow4136659-32" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108712895" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<p><span style="font-size: 24px;">Resume Release </span></p>
<p><br></p>
<p>This section allows you to give JFS Employment Services staff permission to release to an employer. Please check on of the choices. This release is subject to revocation by the undersigned at any time except to the extent that action has
already been taken. Revocation must be submitted via email or in writing.</p>
</div>
</div>
<div id="fsRow4136659-33" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108713032" lang="en" fs-field-type="checkbox"
fs-field-validation-name="I GIVE Jewish Family Service permission to release my resume to an employer WITHOUT my written permission. ">
<fieldset role="group" aria-labelledby="fsLegend108713032" id="label108713032">
<legend id="fsLegend108713032" class="fsLabel fsRequiredLabel fsLabelVertical"><span>I GIVE Jewish Family Service permission to release my resume to an employer WITHOUT my written permission. <span class="fsRequiredMarker">*</span></span>
</legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field108713032_1"><input type="checkbox" id="field108713032_1" name="field108713032[]" value="Yes" class="fsField fsRequired vertical" aria-required="true">Yes</label>
<label class="fsOptionLabel vertical" for="field108713032_2"><input type="checkbox" id="field108713032_2" name="field108713032[]" value="No" class="fsField fsRequired vertical" aria-required="true">No</label>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-34" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell108710803" lang="en" fs-field-type="checkbox"
fs-field-validation-name="I understand that in the event of a change in my scheduled appointment, JFS will attempt to contact me. I give permission for JFS to contact me. Please check all that apply. You list another phone number, email and name in the other option. ">
<fieldset role="group" aria-labelledby="fsLegend108710803" id="label108710803">
<legend id="fsLegend108710803" class="fsLabel fsRequiredLabel fsLabelVertical"><span>I understand that in the event of a change in my scheduled appointment, JFS will attempt to contact me. I give permission for JFS to contact me. Please
check all that apply. You list another phone number, email and name in the other option. <span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field108710803_1"><input type="checkbox" id="field108710803_1" name="field108710803[]" value="Leave a message on my cell phone listed on this form" class="fsField fsRequired vertical"
aria-required="true">Leave a message on my cell phone listed on this form</label>
<label class="fsOptionLabel vertical" for="field108710803_2"><input type="checkbox" id="field108710803_2" name="field108710803[]" value="Leave a message on my home phone listed on this form" class="fsField fsRequired vertical"
aria-required="true">Leave a message on my home phone listed on this form</label>
<label class="fsOptionLabel vertical" for="field108710803_3"><input type="checkbox" id="field108710803_3" name="field108710803[]" value="Leave a message through the email listed on this form" class="fsField fsRequired vertical"
aria-required="true">Leave a message through the email listed on this form</label>
<div class="vertical fs-clear">
<label class="fsOptionLabel vertical" style="margin-right: 5px;" for="field108710803_other"><input type="checkbox" id="field108710803_other" name="field108710803[]" value="Other" class="fsField fsRequired"
aria-required="true">Other:</label>
<input type="text" id="field108710803_othervalue" name="field108710803_other" size="15" class="fsOtherField" aria-required="true"><label class="hidden" for="field108710803_othervalue">Other Value</label>
</div>
</div>
</fieldset>
</div>
</div>
<div id="fsRow4136659-35" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101728109" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<p>Please be assured that your information is kept confidential. Alexander JFS Career and Employment Services provides client information only to a potential employer as part of a referral to a job possibility. We request that you
notify us when you obtain employment. We request permission to contact you via phone or email about job opportunities and additional job search related information. </p>
<p>By signing below, you certify the information submitted here is accurate and that you agree to abide by JFS Employment Services guidelines. I have read and/or had explained to me and understand The Notice of Privacy Policies and
Practices and Welcome to Alexander JFS. My questions have been answered. I understand that if I have additional questions, I should direct these to my counselor/case manager or his/her supervisor. By signing below, I give my consent to
services as described in these documents. </p>
<p><br></p>
</div>
</div>
<div id="fsRow4136659-36" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101728211" aria-describedby="fsSupporting101728211" lang="en" fs-field-type="signature" fs-field-validation-name="Signature">
<label id="label101728211" class="fsLabel fsRequiredLabel" for="field101728211">Signature<span class="fsRequiredMarker">*</span> </label>
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<div id="signature101728211" class="fsSignature">
<div style="padding:0 !important;margin:0 !important;width: 100% !important; height: 0 !important;margin-top:-1em !important;margin-bottom:1em !important;"></div><canvas
style="margin: 0px; padding: 0px; border: none; height: 160px; width: 100%;" class="jSignature" width="638" height="160"></canvas>
<div style="padding:0 !important;margin:0 !important;width: 100% !important; height: 0 !important;margin-top:-1.5em !important;margin-bottom:1.5em !important;"></div>
</div>
<div style="text-align: right">
<a href="javascript://" class="fsSignatureClear" id="signatureClear101728211">
[clear]
</a>
</div>
<input type="hidden" id="field101728211" value="" name="field101728211" required="" class="fsField fsRequired" aria-required="true">
<div id="fsSupporting101728211" class="fsSupporting">Use your mouse or finger to draw your signature above</div>
</div>
</div>
<div id="fsRow4136659-37" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell101728214" lang="en" fs-field-type="datetime" fs-field-validation-name="Date">
<fieldset role="group" aria-labelledby="fsLegend101728214" id="label101728214">
<legend id="fsLegend101728214" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Date<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
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<div class="hidden"><label for="field101728214M">Month</label></div>
<select id="field101728214M" name="field101728214M" class=" fsField fsRequired" aria-required="true">
<option value=""> </option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
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<div class="hidden"><label for="field101728214D">Day</label></div>
<select id="field101728214D" name="field101728214D" class=" fsField fsRequired" aria-required="true">
<option value=""> </option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<div class="hidden"><label for="field101728214Y">Year</label></div>
<select id="field101728214Y" name="field101728214Y" class=" fsField fsRequired" aria-required="true">
<option value=""> </option>
<option value="2018">2018</option>
<option value="2019">2019</option>
<option value="2020">2020</option>
<option value="2021">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
<option value="2025">2025</option>
<option value="2026">2026</option>
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* Services Request Service Donate * About Us * Resources & News * Houston Jewish Family Foundation * Shop Celebration Company what are you searching for? * About Us * Leadership * Our Impact * Financials * Contact Continually measuring our impact to improve the quality of our services. Our Impact * Services Services Behavioral & Mental Health Services Licensed mental health professionals assist adults, adolescents, children and families to improve their overall well-being. Coaching & Case Management Providing individuals and families with access to information related to life’s challenges. Disability Services Enriching and empowering individuals with disabilities, their families and caregivers. Career and Professional Development Vocational rehabilitation services, job counseling, assessment, placement and support. Jewish Chaplaincy Providing spiritual comfort and guidance for patients and their families. Explore all services * Services * Events * Get Involved Get Involved Ways to Give Volunteer & Teen Opportunities Family Activities For the Good of Life Campaign Request Service Donate * About Us About Us Leadership Our Impact Financials Contact US * Resources & News * Houston Jewish Family Foundation Houston Jewish Family Foundation * Shop Celebration Company Request Service Donate Explore All Services We offer a family of services that support and transform the lives of individuals, families and communities. JFS Services Covid-19 See how JFS can help you deal with the impact of the pandemic. Learn More Behavioral & Mental Health Services Licensed mental health professionals assist adults, adolescents, children and families to improve their overall well-being. Counseling High-quality therapy for both adults and children. AdultsChildren & TeensGrief & LossIntensive Outpatient ProgramSupport Groups / Individual SessionsInsurance & FeesPay My Bill Community intervention Programs to raise awareness and knowledge. PreventionWellnessMental Health First AidSources of StrengthSubstance MisuseTouching the Heart Professional Development Continuing education for students and professionals in the mental health field. Continuing Clinical Eduction (CEU)Clinical Supervision & ConsultationPlay Therapy TrainingClinical Internships Community Request Providing resources to communities affected by loss or trauma. Continuing Clinical Eduction (CEU)Clinical Supervision & ConsultationPlay Therapy TrainingClinical Internships Suicide Prevention Coaching & Case Management Providing individuals and families with access to information related to life’s challenges. Senior Adult Helping seniors stay independent for as long as possible. Direct ServicesSenior OutreachSenior Chavurot Disaster Services Guiding those impacted through a long-term recovery. COVID-19Winter Storm 2021Disaster PreparednessFlood AssistanceHurricane PrepardnessDisaster Resources Financial Stability Providing classes and resources. Student Loans & ScholarshipsCaregiver Financial Empowerment Study Student Loan & Scholarship Enim ullamcorper viverra hendrerit sed ut. Family & Children Helping parents and families address the root of challenges they experience. Disability Case Management Providing access to information, referrals and planning. Holocaust Survivors Disability Services Enriching and empowering individuals with disabilities, their families and caregivers. Celebration Company An entrepreneurial employment program for adults with disabilities. About the Celebration CompanyAdmissionsCenter for Art & PhotographyCelebration Company News Shop Celebration Company Community Programs Focusing on inclusion and independence. EmploymentSocial SupportTransition Aged Programs Alexander Institue for Inclusion Lowering stigmas related to people with disabilities. About the InstituteCommunity Advocacy ReelAbilities disability Case Management Providing access to information, referrals and planning. disability Resource Guide Career & Employment Center Guiding individuals through the job search process and providing qualified applicants to employers. Career Guidance for Professionals Coaching and resources for job-seekers and those planning to change careers. Employer Services Strengthen your workforce with new talent and inclusion. Career Guidance for Individuals with Barriers A job counseling service to assist individuals with disabilities. More Contact Us About Us Pay my bill staff Chaplaincy Providing spiritual comfort and guidance for patients and their families. Direct Services Including home visits, family meetings, information and referrals. Community connections Offering a variety of resources and information. Local SynagoguesJewish OrganizationsKosher Food and RestaurantsTemporary Housing Hospital Partners Serving the Texas Medical Center WAYS TO GIVE VOLUNTEER & TEEN OPPORTUNITIES FAMILY ACTIVITIES FOR THE GOOD OF LIFE CAMPAIGN Explore The Career & Employment Center * Career & Employment Center * * The Career and Employment Center Intake Form THE CAREER & EMPLOYMENT CENTER INTAKE FORM Thank you for choosing the Alexander JFS Career & Employment Center to assist you in your job search. COMPLETE INTAKE FORM Please complete the Career & Employment Center Intake form to begin receiving services from Alexander JFS. Your information is kept confidential. Alexander JFS Employment Services provides client information only to authorized public funding agencies or, with your knowledge, to a potential employer as part of a referral to a job possibility. Contact Us Directly jfsemployment@alexanderjfs.org (713) 667-9336 Hours of Operation 8:30 AM - 8:00 PM Monday 8:30 AM - 5:30 PM Tuesday - Thursday 8:30 AM - 4:00 PM Friday Please fill in a valid value for all required fields Please ensure all values are in a proper format. Are you sure you want to leave this form and resume later? Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form. Save and Resume Later Save and get link You must upload one of the following file types for the selected field: There was an error displaying the form. Please copy and paste the embed code again. Apply Discount You saved with code Submit Form Submitting Validating There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue. Please check the field: Fields Alexander JFS Career and Employment Services Intake Form Name* First Name* Last Name* Address* Address Line 1 Address Line 2 City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands (US) Virginia Washington West Virginia Wisconsin Wyoming Armed Forces (the) Americas Armed Forces Europe Armed Forces Pacific Army Post Office (U.S. Army and U.S. Air Force) Fleet Post Office (U.S. Navy and U.S. Marine Corps) State ZIP Code Email* Cell Phone* Birthdate* https://jewishfamilyservicesajivu.formstack.com/forms/images/2/calendar.png Month 01 02 03 04 05 06 07 08 09 10 11 12 Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 United States Veteran* Civilian Veteran Active Duty Widow/Widower of Veteran Not Disclosed Marital Status* Divorced Married Single Separated Widowed Other: Other Value Race* African American/Black African Asian /Asian American Hispanic/LatinX or Spanish Origin (any race) Indigenous People or Native Americans (American Indian or Alaska Native) Middle Eastern or North African Multiracial (Two or more races) Native Hawaiian or Other Pacific Islander White Not listed Unknown Religion Sex* Female Male Other: Other Value Gender Identity Female Male Non-binary (non-conforming) Transgender Female Transgender Male Not listed/other Personal Gender Pronouns* He/Him/His She/Her/Hers They/Them/Theirs Other: Other Value Primary language: Highest Level of Education. Single choice* High School/GED Some College Vocational Certification: VAST Academy or other program Technical Certification Associates Degree Bachelor Degree Master Degree Ph.D Professional Degree - JD Professional Degree - MD Other: Other Value Occupation - Please enter either your most recent job title or the job title you want to have.* Financial Information We collect financial information to determine the fee which is based on a sliding scale. It is determined by your household income and number of people living in your household. Monthly Income* Number of people living in your household (include all adults and children)* Job Readiness Questions This section will help us determine your job search needs. Job Readiness Questions Job Readiness Questions Yes No I do not know I know the qualifications for jobs I am applying. Job Readiness Questions: I know the qualifications for jobs I am applying. (Yes) I know the qualifications for jobs I am applying. (No) I know the qualifications for jobs I am applying. (I do not know) I have a job search plan with timelines. I have a job search plan with timelines. (Yes) I have a job search plan with timelines. (No) I have a job search plan with timelines. (I do not know) I can write a cover letter. I can write a cover letter. (Yes) I can write a cover letter. (No) I can write a cover letter. (I do not know) I have a networking list. I have a networking list. (Yes) I have a networking list. (No) I have a networking list. (I do not know) I have had a mock interview. I have had a mock interview. (Yes) I have had a mock interview. (No) I have had a mock interview. (I do not know) I have a LinkedIn account. I have a LinkedIn account. (Yes) I have a LinkedIn account. (No) I have a LinkedIn account. (I do not know) I have a Work in Texas profile. I have a Work in Texas profile. (Yes) I have a Work in Texas profile. (No) I have a Work in Texas profile. (I do not know) I have had at least one face to face networking meeting. I have had at least one face to face networking meeting. (Yes) I have had at least one face to face networking meeting. (No) I have had at least one face to face networking meeting. (I do not know) I can complete a job application online. I can complete a job application online. (Yes) I can complete a job application online. (No) I can complete a job application online. (I do not know) I have prepared answers for questions during an interview. I have prepared answers for questions during an interview. (Yes) I have prepared answers for questions during an interview. (No) I have prepared answers for questions during an interview. (I do not know) I have access to a computer to complete my job search. I have access to a computer to complete my job search. (Yes) I have access to a computer to complete my job search. (No) I have access to a computer to complete my job search. (I do not know) Do you have a disability? Check all that apply.* None Hearing or vision Walking Daily activities such as dressing/bathing Concentrating or focusing on details Making decisions Visiting a doctor alone or running errands Physical condition Intellectual or Developmental Condition Are you a customer of Texas Workforce Commission, Vocational Rehabilitation department (formerly DARS)?* Yes No Maybe Name of Counselor* Are you legally authorized to work in the United States?* Yes No * Do you have a green card? Do you have a work permit? What job would you like to have?* I have been out of work for:* Less than 1 year 1 - 2 years 3 plus years I need further training on: Select all that apply* Completing a job application Effective resumes and cover letters Interviewing techniques Job search readiness Networking strategies Do you have a resume?* Yes No Upload most current resume* No File Chosen File uploads may not work on some mobile devices. Resume Release This section allows you to give JFS Employment Services staff permission to release to an employer. Please check on of the choices. This release is subject to revocation by the undersigned at any time except to the extent that action has already been taken. Revocation must be submitted via email or in writing. I GIVE Jewish Family Service permission to release my resume to an employer WITHOUT my written permission. * Yes No I understand that in the event of a change in my scheduled appointment, JFS will attempt to contact me. I give permission for JFS to contact me. Please check all that apply. You list another phone number, email and name in the other option. * Leave a message on my cell phone listed on this form Leave a message on my home phone listed on this form Leave a message through the email listed on this form Other: Other Value Please be assured that your information is kept confidential. Alexander JFS Career and Employment Services provides client information only to a potential employer as part of a referral to a job possibility. We request that you notify us when you obtain employment. We request permission to contact you via phone or email about job opportunities and additional job search related information. By signing below, you certify the information submitted here is accurate and that you agree to abide by JFS Employment Services guidelines. I have read and/or had explained to me and understand The Notice of Privacy Policies and Practices and Welcome to Alexander JFS. My questions have been answered. I understand that if I have additional questions, I should direct these to my counselor/case manager or his/her supervisor. By signing below, I give my consent to services as described in these documents. Signature* [clear] Use your mouse or finger to draw your signature above Date* https://jewishfamilyservicesajivu.formstack.com/forms/images/2/calendar.png Month 01 02 03 04 05 06 07 08 09 10 11 12 Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 Thank you for choosing Alexander JFS Career and Employment Services to assist you in your job search. Previous← Next→ Enter your save and resume password Cancel Confirm Online Form - Employment Services Intake Powered by Formstack Contact Us Directly jfsemployment@alexanderjfs.org (713) 667-9336 Hours of Operation 8:30 AM - 8:00 PM Monday 8:30 AM - 5:30 PM Tuesday - Thursday 8:30 AM - 4:00 PM Friday No items found. RESOURCES & NEWS A central location for you to be empowered with knowledge. Explore JFS Central Carl’s Daily , Community Choice - August 19, 2020 Careers and Employment , Alexander JFS Career and Employment Center Fees and Payment Careers and Employment , Disability Services Hiring Employees with Disabilities Carl’s Daily , Failing Forward Towards Success - April 12, 2021 Support Alexander JFS We rely on the gifts of many to deliver our services. Please consider being a partner in our vital work. Donate Now Light Hope Help Joan and Stanford Alexander Jewish Family Service 4131 S Braeswood Blvd Houston, TX 77025 Tax ID: 74-1152607 (O) 713-667-9336(F) (713) 667-3619(E) info@alexanderjfs.org Follow Celebration Company InstagramFacebook Explore What We Do CalendarAll ServicesBehavioral & Mental HealthCoaching & Case ManagementDisabilityCareer & Employment CenterChaplaincyCareers at Alexander JFS Support Our Work Donate Shop Celebration Company Houston Jewish Family Foundation ReelAbilities Festival MediaContact Follow Celebration Company InstagramFacebook Log On BMHS Client PortalBoard Member PortalLeo Project Portal Member of Partner Agency of Beneficiary of Social services for Jewish Nazi victims have been supported by a grant from the Conference on Jewish Material Claims Against Germany. Family Matters E-News Signup First NameLast NameI am interested in...Select one...General InterestBehavioral & Mental Health ServicesDisability ServicesEmployment ServicesMusic & Spirit ProgramReelAbilitiesVolunteersEmailMobile Number Thank you! Your submission has been received. Something went wrong while submitting the form. Member of NJHSA Partner Agency of JFGH Beneficiary of UWGH Social services for Jewish Nazi victims have been supported by a grant from the Conference on Jewish Material Claims Against Germany. 2020 Copyright Accessibility StatementAnti Discrimination PolicyPrivacy Statement