Please fill out this information to make a referral The Smart Workforce Center. County - Select -Del NorteShastaSiskiyouTrinity Referral From: CalFresh CalWORKS Castle Rock Charter School Child Support College of the Redwoods Department of Rehabilitation EDD/Veterans Services Del Norte Child Care Council Health and Human Services NCIDC (Northern CA Indian Development Council) Probation/Parole/DRC Other… Enter other… Referral From: AARP/SCSEP American Career Training CalFresh CalWORKS Changing Tides Family Services Child Support College of the Redwoods CR Truck School Department of Rehabilitation EDD/Veterans Services Family Resource Centers Health and Human Services Healthy Moms Program Humboldt County Alcohol and Other Drugs Humboldt State University Tribal TANF Probation/Parole/DRC Other… Enter other… Referral From: American Career Training CalFresh CalWORKS Child Support CIMC College of the Redwoods Department of Rehabilitation EDD/Veterans Services Head Start Child Development Health and Human Services Institute of Technology Parent Partners Probation/Parole/DRC Public Health Shasta College Simpson University Trinity Office of Education West Harbor Training Center Other… Enter other… Referral From: Adult Education Services CalFresh California Conservation Corps CalWORKS Child Support College of the Redwoods College of the Siskiyous Community Resource Centers Economic Development Center EDD/Veterans Services Head Start Child Developement Health & Human Services Housing Authority Humboldt State University Jefferson Economic Development Institute Karuk Human Services/TANF Probation/Parole/DRC Other… Enter other… Referral From: American Truck School CalFresh CalWORKS Child Support Department of Rehabilitation EDD/Veterans Services Head Start Child Development Health and Human Services Human Response Network Probation/Parole/DRC Public Health Shasta College Tribal TANF Trinity County Office of Education Trinity Together Other… Enter other… Customer Being Referred: Customers Name Phone Email The customer being referred is aged 18-24 Yes No The customer being referred is unemployed Yes No The customer being referred is currently receiving unemployment benefits? Yes No The customer being referred has exhausted unemployment benefits? Yes No Employment Goals (check all that apply): Full Time Part Time Paid On-the-Job Training Attend College Vocational School Other… Enter other… Referring Staff Referring Staff Staff Name? Referring Agent Phone? Referring Agent Email? Referring Agent Fax? Referral For: Truck School CA Training Benefits Info Employment Development Department (EDD) GED Referral Job Referrals Resume Assistance Special Grants - Disaster Special Grants - Opioid Unemployment (eligible or exhausted) Workforce Innovation and Opportunity Act (WIOA) Program Information (Young Adult/Adult/Dislocated) Workshops Other… Enter other… Referral For: American Truck School CA Training Benefits Info Employment Development Department (EDD) GED Assistance/Referral Job Referrals Resume Assistance Special Grants - Disaster Special Grants - Prison to Employment (P2E) Typing/10 Key Certificates Unemployment (eligible or exhausted) Workforce Innovation and Opportunity Act (WIOA) Program Information (Young Adult/Adult/Dislocated) Workshops West Harbor Training Center Other… Enter other… Additional Information About Referral: CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit
