Job Search | hauc4u

Job Seeker Intake Form

Tell us about your job goals so HAUC can offer resources and referrals. Employment is not guaranteed. Fields marked * are required. Do not include Social Security numbers, banking information, immigration documents, or medical records.

1. Contact Information

First name

Last name

City/town, state, and ZIP code

Cell phone

Email (optional)

Preferred contact method

Best days and times to contact you

Preferred language

Would you like an interpreter?

2. Job Goals and Availability

What jobs or job titles are you looking for?

Industries of interest (for example, healthcare, retail, hospitality, construction, driving, office, technology)

Current employment situation

Type of work desired: full-time, part-time, temporary, seasonal, or apprenticeship

Available days, hours, and shifts (days, evenings, overnight, weekends)

Earliest date you can start

Preferred work location

Cities/areas you can work in and maximum travel time each way

Desired pay (include hourly or yearly; indicate if negotiable)

3. Experience, Education, and Skills

Most recent/relevant job: title, employer/industry, and dates worked

Main responsibilities and accomplishments

Other relevant jobs, volunteer/unpaid work, and total years of experience

Highest education/training completed

Relevant degrees, certifications, licenses, training, and expiration dates

Skills you can offer

Languages you speak and level of fluency

Do you have a résumé?

Optional résumé link

Are professional references available? Do not provide their contact details here.

4. Transportation and Employment Readiness

Do you have reliable transportation to work?

Transportation available (vehicle, public transit, rides, or other)

If seeking a driving job: do you hold the required valid license? Include license class, or write Not applicable.

Are you currently authorized to work in the United States?

Do you need a referral for employment-authorization guidance?

5. Support Requested

How can HAUC help? Résumé, applications, interviews, job openings, computer skills, English classes, training, foreign credentials, transportation, childcare, work clothing, or other.

Would you like to discuss an accessibility need or accommodation privately? No medical details are needed.

Interested in job-readiness workshops or job fairs?

How did you hear about HAUC?

Anything else you want HAUC to know about your job search?

6. Permission and Acknowledgment

HAUC offers employment resources and referrals and does not guarantee a job. Choosing No to sharing does not prevent you from requesting other assistance.

May HAUC contact you about this request?

May HAUC send you future job alerts or workshop information? (Optional)

May HAUC share your résumé and relevant job-search information with employers or employment partners? (Optional)

I confirm my information is accurate to the best of my knowledge and understand HAUC does not guarantee employment.

Type your full name to acknowledge