Disclaimer: Completing this application does not constitute enrollment in SCSEP. This is a needs-based program; applications will be processed according to program availability. 

Contact Information
* Name
0/50
* Phone Number
0/50
* Email
0/50
* Address
0/50
* State/County of residence
0/50
* Are you 55 years old or older?
* Size of household?
People
People
Question Text
* Do you currently have any income? Select all that apply.
0/250
* Have you previously enrolled in any Senior Community Service Employment Program (SCSEP)?
* Are you currently employed?
* Do you have a current resume?
* Desired Occupational Field. Select the option that most closely aligns with your employment goals.
0/250
* Please select any of the following characteristics that can be used to describe you. Priority is shown towards people with multiple barriers. (Select all that apply)
Question Text
Question Text
Submit Survey
If you just opted in, you're consenting to receive marketing emails from: The WorkPlace, 1000 Lafayette Blvd , Bridgeport, CT 06604. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact