Operation Skillbridge Intake

Operation Skillbridge

OPERATION SKILLBRIDGE is an industry-driven, community-led initiative to reboot the lives and careers of transitioning service members and veterans in order to close the skills gap, promote economic opportunities, and stimulate civic engagement and coordinated access to ongoing community reintegration services for veterans and their families.*Any certificate Training Programs are required to take the REBOOT Workshop Prior.

Military Service













Command Information





War Served






Employment Information
If you are not employed, please answer the following questions:




Page 2 - Personal Information

Personal Information














non-military email address







(to select more that 1 option hold down the control button)
Please Rate your experience of the following on a scale of 1 to 5:

1 - No Knowledge
2 - Beginner
3 - Basic
4 - Intermediate
5 - Advanced
1 2 3 4 5
Living Situation



Family Information


Total household Gross wages and salaries before deductions.
Emergency Contact Information



Referral Information




Services Provided

Follow Up Agreement

Page 3 - Workshop Pre-Survey

The following questions are part of a pre-REBOOT workshop survey. Your responses will have no bearing on your application to attend a workshop. We collect this information to evaluate the REBOOT workshop and the data can help us obtain more funding so that additional veterans can attend. Please answer all questions.          

              

For each statement below, please read carefully and indicate how much confidence you have that you could accomplish each of these tasks or beliefs by marking your answer according to the following 5-point scale.

1 = No Confidence

2 = Very Little Confidence

3 = Moderate Confidence

4 = Confidence

5 = Complete Confidence













































Additional Questions




Page 4 - Photograph and Video Consent to Release

I hereby grant the National Veterans Transition Services, Inc. (NVTSI) permission to use my likeness in a photograph or video in any and all of its publications, including web site entries, without payment or consideration.


I understand and agree that these materials will become the property of the National Veterans Transition Services, Inc. and will not be returned.


I hereby irrevocably authorize the National Veterans Transition Services, Inc. to edit, alter, exhibit, publish or distribute this photo for the purposes of publicizing the National Veterans Transition Services, Inc.’s programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive my right to royalties or any other compensation arising or related to the use of the photograph.


I hereby hold harmless and release and forever discharge the National Veterans Transition Services, Inc. from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.


I am 21 years of age and am competent to contract in my own name. I have read this release and I fully understand the contents, meaning, and impact of this release.