The Dannon Project: Application
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  • The Dannon Project: Application

    Please complete the form below. An asterisk marks a required field.
  • Date of Application*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • EDUCATION INFORMATION

  • Have you ever been expelled from school?
  • Did you attend college?
  • Do you need your GED or High School Diploma?*

  • MILITARY SERVICE

  • Are you a Veteran?*
  • If yes, do you have your DD214?
  • Are you currently receiving any Veteran Services?

  • INCARCERATION INFORMATION

  • Have you been arrested?*
  • If yes, Date of Arrest
     - -
  • If yes, what were you arrested for? (choose any or all that apply)*
  • Do you have an Active Court Case?*
  • Have you ever been In Jail, Prison, or Juvenile Detention?*
  • Are you currently In Jail, Prison, or Juvenile Detention?*
  • If yes, Date of Incarceration*
     - -
  • Past/Upcoming Release Date
     - -
  • Are you on State or Federal SRP (Supervised Release Program)*
  • Choose any or all that apply to you*
  • Choose any or all of the following that apply to you*
  • Are You On Supervised Probation (Electronic Monitoring)?*

  • EMPLOYMENT INFORMATION

  • Are you currently employed?*
  • Do you receive TANF Benefits*

  • SUPPORTIVE SERVICES

  • Which Supportive Services do you need (Check all that apply)?

  • PERSONAL GOAL SETTING

  • APPLICANT ACKNOWLEDGEMENT & CONSENT

    Acknowledgement of Information

  • I acknowledge that the above and the attached information is true to the best of my knowledge. I understand that I may be asked to provide documents of proof to verify the information. I will willfully provide. I further understand that providing false information to The Dannon Project for admissions in its program or for any reason may result in immediate termination from the program. I understand that if The Dannon Project requests that I provide additional information to determine my eligibility for enrollment that I must adhere to the requests thoroughly and within a reasonable time frame. I understand that if I am not accepted into any Dannon Project Programs, that I will be notified of reasons for termination or denial.

  • Clear

  • CONSENT FOR RELEASE OF INFORMATION

  • I authorize and provide consent to The Dannon Project funders and collaborative partners to release information gathered and collected while you are a participant in The Dannon Project for the expressed purpose of coordinating support services and linkages with federal and state agencies, community organizations, social service agencies, and faith-based programs to assist my transition.

  • Clear
  • Date*
     - -

  • This workforce product was funded by a grant awarded by the U.S. Department of Labor's Employment and Training Administration The product was created by the recipient and does not necessarily reflect the official position of the U.S. Department of Labor. The Department of Labor makes no guarantees, warranties, or assurances of any kind, express or implied, with respect to such information, including any information on linked sites and including, but not limited to, accuracy of the information or its completeness, timeliness, adequacy, continued availability, or ownership. This product is copyrighted by the institution that created it.

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