New Community Workforce Development Center Intake Form
Thank you for your interest in applying to the Job Training and Employment Programs at New Community Workforce Development Center. Take a few minutes to fill out the intake form below so that our staff can better serve you. Please expect to hear from us within 1 to 2 business days. To contact Workforce, call 973-824-6484 or email Rodney Brutton at
. Workforce is located at 274 South Orange Avenue, Newark, NJ, 07103, fax: 973-824-6545.
Cell Phone Number
Home Phone Number
Date of Birth (ex. 10/12/85)
Do you possess a valid New Jersey driver's license?
Do you have a high school diploma?
I am currently enrolled in a GED class
Have you ever applied for or been awarded financial aid?
I am not sure
Please check off the boxes for any program(s) that you are interested in:
Patient Care Technician
Certified Medical Assistant
Construction Building Trades (carpentry, electrical, plumbing, painting, etc.)
Ford Automotive Technician
Certified Home Health Aid (New Jersey Board of Nursing License)
How did you hear about us?
New Community website
Referral from family or friend
Flyer or brochure
New Community Family Resource Success Center
Do you have any questions/comments for us? If so, let us know here:
Thank you for completing the intake form. For more details on each training program, visit our website:
. Our staff will be in contact with you within 1-2 business days. We look forward to having you join our program!
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