Interest Form
Disclaimer: This form is intended to gather interest and best align participants to current and upcoming DWD projects compatible with one's experience and interest. Please understand, not every DWD project and/or participant will be assigned to their preferred interest in scope of work if current DWD projects require project specific support.
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
How can we contact you?
*
Phone
Email
Other
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Text messaging
*
By checking this box you consent to receiving text messages from Dignified Workday
Email
*
example@example.com
Are you a veteran?
*
Yes
No
How many hours would you like to work per week?
*
Do you have any concerns about losing benefits due to hours of work?
*
Yes
No
Which benefits?
*
Food stamps
SSI
Unemployment
TANF
Other
Would you like to work more than 2 hours per week?
*
Yes
No
How many hours per week can you work?
*
What is your educational background (or highest attained)?
*
Please Select
Some high school
High school diploma/GED
Some college
AA
BA
MA
PhD
What is your current living situation?
*
Please select any obstacle(s) you have that may prohibit you from working more
*
Transportation
Physical/mental limitation or disability
Legal issues
Other
Not Applicable
Please list the obstacle(s) that were not listed
*
Do you have the documents required to legally work in the US? (ex. govt issued ID, social security card, passport, etc.)
*
Yes
No
Which of these documents do you have?
*
Government issued ID
Valid drivers license
Social security card (or receipt from SSA)
Passport
If not, what is the status of these?
*
What assistance are you currently receiving?
*
Food stamps
Apple Health
TANF
Cash assistance
SSDI
SSI
None
Other
May we include a headshot for our files? If so, please upload below
*
Yes
No
Please select or capture an image:
*
Please upload a current resume if possible
Browse Files
Drag and drop files here
Choose a file
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Please select any of the following you have experience with
*
Cleaning
Painting
Landscaping
Construction
Handyman work
NONE
Other
What other kinds of work experience/skills do you have? Please list the specific skill and years of experience you have.
*
Please list any certifications you currently have
Cleaning Experience
What is your current level of experience in cleaning services?
Beginner (basic knowledge, limited hands-on experience)
Intermediate (some hands-on experience, worked on a few projects)
Advanced (extensive hands-on experience, worked on multiple projects)
How much experience do you have?
*
Please Select
0-11 months
1-2 years
3-4 years
5 years or more
What types of cleaning services are you most interested in providing? (select all that apply)
*
Residential cleaning
Commercial cleaning
Deep cleaning
Post-construction cleaning
Carpet cleaning
Window cleaning
NONE
Other
Painting Experience
What is your current level of experience in painting services?
Beginner (basic knowledge, limited hands-on experience)
Intermediate (some hands-on experience, worked on a few projects)
Advanced (extensive hands-on experience, worked on multiple projects)
How much experience do you have?
*
Please Select
0-11 months
1-2 years
3-4 years
5 years or more
Are you comfortable on a lift or ladder?
*
Yes
No
Can you 'cut in' and edge effectively?
*
Yes
No
Years of experience with 'cut in' and edge painting
*
Have you used an airless sprayer?
*
Yes
No
Years of experience using an airless sprayer
*
What types of painting services are you most interested in providing? (select all that apply)
*
Residential painting
Commercial painting
Graffiti mitigation
NONE
Other
Landscaping Experience
What is your current level of experience in landscaping services?
Beginner (basic knowledge, limited hands-on experience)
Intermediate (some hands-on experience, worked on a few projects)
Advanced (extensive hands-on experience, worked on multiple projects)
How much experience do you have?
*
Please Select
0-11 months
1-2 years
3-4 years
5 years or more
Have you used a chainsaw?
*
Yes
No
Years of experience using a chainsaw
*
Have you commercially sprayed landscape with pesticide or fertilizer?
*
Yes
No
Years of experience spraying pesticide or fertilizer
*
What types of landscaping services are you most interested in providing? (select all that apply)
*
Lawn maintenance
Tree and shrub planting/trimming
Irrigation system installation/repair
Fencing installation
Garden installation and maintenance
NONE
Other
Construction Experience
What is your current level of experience in construction services?
Beginner (basic knowledge, limited hands-on experience)
Intermediate (some hands-on experience, worked on a few projects)
Advanced (extensive hands-on experience, worked on multiple projects)
How much experience do you have?
*
Please Select
0-11 months
1-2 years
3-4 years
5 years or more
What types of construction projects are you most interested in working on? (select all that apply)
*
Residential construction (houses, apartments)
Commercial construction (offices, retail)
Renovation/remodeling projects
NONE
Other
What specific areas of construction interest you most? (select all that apply)
*
Carpentry
Masonry
Roofing
Drywall installation
Supervisor
Layouts and blueprint reading
General labor
NONE
Other
Handyman Experience
What is your current level of experience in handyman services?
Beginner (basic knowledge, limited hands-on experience)
Intermediate (some hands-on experience, worked on a few projects)
Advanced (extensive hands-on experience, worked on multiple projects)
How much experience do you have?
*
Please Select
0-11 months
1-2 years
3-4 years
5 years or more
What specific areas of handyman work interest you most? (select all that apply)
*
Home repairs
Furniture assembly
Fixture installation (lights, fans, faucets)
Appliance repair
Minor electrical work
Minor plumbing work
Door and window repairs
Flooring and tiling
NONE
Other
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