KEYS WFD Application Step 1 of 3 33% Name(Required) First Last Are your currently enrolled in Case Management Services with KEYS?YesNoNot SureWhat KEYS Staff do you work with?(Required)Mel PayneGenece MatthiasKali MerrittKoran RichardsonShalise MarshallAjah DoswellNone of the AboveWho referred you:(Required) First Last This program is specifically offered to individuals who are enrolled in our Case Management Program. If you are interested in applying please visit: https://keysdev.com/tcm-form/ Date of Birth:(Required) MM slash DD slash YYYY Address(Required) Street Address Address Line 2 City ZIP / Postal Code Phone(Required)Email(Required) Industries of Choice:(Required) I'm Not Sure Agriculture, Food and Natural Resources Architecture and Construction Education and Training Business Management and Administration Arts, Audio/Video Technology and Communications Finance Government and Public Administration Health Science Hospitality and Tourism Human Services Information Technology Law, Public Safety, Corrections and Security Manufacturing Marketing, Sales and Service Science, Technology, Engineering and Mathematics Transportation, Distribution and Logistics What I want is not listed Select the professions or careers you would like to work in. Have you worked a job before?(Required)YesNoWill you need assistance with transportation?(Required)YesNoNot SureDescribe 3 of your best skills/traits:(Required)Describe a bad experience you had while working with others:(Required)Describe what the ideal work environment would look for you:(Required)If selected, how would you to be paid?(Required)ZellePayPalCashAppOtherDescribe:(Required) Zelle Information:(Required) PayPal Information:(Required) CashApp Information:(Required) Is there anything else you would like us to know: KEYS Selection StatementKEYS Empowers, Inc. is dedicated to promoting the wellness of all the individuals we serve, especially those who have been deemed to have challenges and limitations. It is our request that while at a placement provided by KEYS you acknowledge your needs that will make this a meaningful work experience. By selecting YES, I ACKNOWLEDGE you are expressing written consent to contact the Director of Workforce Development, Melanie Payne when a situation arises that may impact your employment placement.(Required)YES, I ACKNOWLEDGENo, I do not acknowledgeKEYS Empowers, Inc. will require certain documentation to be submitted weekly to provide updates on your progress. By selecting YES, I ACKNOWLEDGE you agree to provide your placement with any and all necessary information to remain compliant with program documentation.(Required)YES, I ACKNOWLEDGENo, I do not acknowledgeKEYS Empowers, Inc. will be responsible for providing program stipends for hours worked. Payroll hours will be submitted weekly from your placement site. Once hours have submitted payment will be disbursed the following Monday. Please note that if there is a delay with documentation being submitted, disbursement will be forward the following Wednesday.YES, I ACKNOWLEDGENo, I do not acknowledgeSignature:(Required)
