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Create Profile + Intake

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Workforce Intake Form

Required: username, password, first/last name, email, phone, city, state, shift, work type, minimum pay, max commute, challenges/barriers.

Username (required)Password (required) – 5 numbers + 1 special (6 chars)

First Name (required)Last Name (required)

Email (required) – only 1 profile per emailPhone (required)

LinkedIn URL (optional)

City (required)State (required)

Shift (required)Work Type (required)

Minimum Pay (required)Max Commute (required) – miles OR minutes (type it)

Challenges / Barriers (required)

Upload Resume (optional for now — only file name saved)

No file selected yet.

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