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Employment Services Form

Are you currently looking for a job? If so, we look forward to assisting you. Please complete this form and we will contact you. (Please note: Only Berks County residents qualify for our employment services.)

If you need help completing this form, please contact us. A career advisor can assist you.

* indicates required
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Are you 18 or older?
Are you a citizen of the United States?
If not, are you authorized to work in the U.S.?

Applicant Information:

Are you available for work?
Do you have access to reliable transportation?
Do you need ADA assistance?
Are you looking for support with ESL/GED Classes?
Are you interested in volunteering?
If so, how many hours per week can you volunteer?


Provide information related to educational background.

Diploma or Degree
Diploma or Degree
Diploma or Degree

Employment History

Please provide your information about your previous employment. Start with your present or most recent job.


In relation to your skills in this section, our interest is not only to know your mastery of the skill. Our interest is also to help you if you want to develop them.

Do you speak English?
Are you able to perform basic computer skills?
Do you have basic Microsoft Office skills?

Thanks for providing your information.

If you do not have a formal resume and need assistance with developing a resume, please contact us at We can help you!

Thank you for your interest! We look forward to assisting you!

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