OC One Stop Registration Form

[ * ]: Required Field

Personal Information

Employment Considerations

Last Employer

What services are you seeking?

Barriers related to employment and job retention

Release of Information

I understand it might be necessary to share my information to help me find a job. Therefore, I give permission for my information to be shared by the One-Stop Center partner agencies staff only. I also authorize E.D.D. to release information regarding the status of my unemployment claim to the County of Orange Workforce Investment Act (WIA) representatives that will assist in the processing of my program eligibility and employment status. I understand that any information I have supplied is subject to verification. I also have read the Equal Opportunity (EO) Policy and Rules of the Center and agree to adhere to these policies.