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Employment and Training Services Referral Form

  1. Employment and Training Services Form
    Please complete this form and a staff member will be in contact with you. If you would like more information, please call any Orange County DSS location at (919) 245-2800 or NC Works/ Skills Development Center at (919) 245-4335.
  2. JOB SEEKER INFORMATION
  3. REFERRAL SOURCE
  4. Veteran?
  5. Do you receive Public Assistance? If so, please indicate which:
    Check all that apply
  6. Services of Interest
    Check all that apply
  7. Challenges to Employment/ Training
    Check all that apply
  8. Leave This Blank: