This intake form helps service providers collect key information about individuals’ personal, educational, and professional backgrounds. It is intended to guide support in areas like career development, credential evaluation, and education. Completing the form should take about 10–15 minutes. After completing the form, make sure to gather the relevant documentation the client can access.
Note: This form is intended to be used as a template and customized to align with your program’s unique needs and specific compliance requirements. This document should not be regarded as a complete compliance tool for any particular grant or program. Please refer to your agency’s cooperative agreements for program-specific requirements.
