The RemoteWorks program aims to help Connecticut residents re-enter the workforce by offering support in job search, career counseling, technology-related skills, as well as customer service and sales training that are essential for telecommuting positions.


Please answer all questions on the application below including contact information so we are able to follow up with you. It is important to check your email and voicemail during the next week. If we cannot reach you, you will not be considered.

Demographic Information


* First Name
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* Last Name
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* Email
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* Street Address
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* City or Town
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* State
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* Zip Code
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* Cell Phone
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Home Phone
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* Date of Birth (must be entered in the following format mm/dd/yyyy)
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* Gender
* Race
* Ethnicity
* Are you authorized to work in the United States?
* Are you a Veteran?
* Have you registered with Selective Service? (males only born after 1960)

Household Size & Income
* Are you currently experiencing long term unemployment?
* What is your unemployment benefit status?
If you are currently collecting benefits, please indicate the date when your benefits will expire. Must be entered in the following format MM/DD/YYYY
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* Do you have any means of income in addition to unemployment insurance? (Select all that apply)
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* What is your household size?
* Is there another adult in your household (over 21) with employment?
* What is your current total annual household income from all sources?
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* Do you own your home?

Employment history based on your most recent employment.
* What was your last day worked?
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* Employer Name
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* Job Title
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* Hours per week
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* Hourly Earnings at your last Employer?
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* Annual Earnings at your last Employer?
* Length of Unemployment (in years and months - example 1 year 4 months)
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* Reason for Separation
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* What was your primary occupation?
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Educational History
* Highest of Secondary Education Completed
* Highest of Post-Secondary Education Completed
* During this period of unemployment, have you returned to school or taken further training? If yes, please describe the academic programs or training.
* Please describe any volunteer service, unpaid internships and/or other activities you have engaged in during this period of unemployment.
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* Please indicate any services that you have received through an American Job Center. (Select all that apply)
* If you have received services through an American Job Center, please indicate which location.

Job Search
* How many hours per week do you spend searching for full-time employment?
* Is your resume current?
* Do you have a LinkedIn account?
* Why do you want to work remotely?
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* What types of jobs have you applied for?
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* How many job interviews have you been on in the past 6 months? (Include both in-person and telephone interviews)
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* What are your weaknesses as they relate to your job search?
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* If you were offered a full-time position, what starting salary would be acceptable to return to work?
* How far are you willing to travel for work (one-way)?
* Please indicate your urgency to return to work.
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* Please select the training location that is most suitable for you.
* What is your primary means of transportation?
* How did you hear about RemoteWorks? If Other, please explain.
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Thank you for completing the application. Your submission will be reviewed shortly. If you have any questions, please do not hesitate to reach out by email at [email protected].

 

We look forward to helping you on your journey to return to work.  

 

Please monitor your email and voicemail. If we can't reach you, we can't assist you! 
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