JVS Workshop Registration

To Pre-Register for JVS Workshops:

1. Complete this form and hit the submit button.


2. Complete and print (ctrl P) this form and mail to:

Attention: Wendy Verba
225 Bush Street, Suite 400
San Francisco, CA 94104


3. Complete and fax this form to: (415) 391-3617 / Attention: Wendy Verba


4. Drop in during business hours to register at our office

JVS asks for the information below for statistical purposes. These statistics help to secure
future funding for JVS. Your information will be kept strictly confidential.

Last Name



First Name









Zip Code



Phone (home)


Phone (cell)


E-mail address


Date of Birth (mm-dd-yyyy)



1. Where did you find out about this workshop? (Check all that apply)

Public agency (e.g., EDD, Human Services Agency, Dept. of Rehabilitation)


Jewish organization (e.g., Jewish Family and Children’s Services, synagogue, JCC)


School (e.g., City College, SFUSD, community     college)


Other social service agency or community organization (e.g., Goodwill, Toolworks, CVE)


Media (newspaper, internet, radio)


Community event (e.g., job fair, street fair)




JVS (website, internet, staff)


Friend/family member/co-worker



2. I am interested in these other services at JVS. Please check all that apply:

  Job Search Assistance

 Career Coaching

 Job search workshops and support groups

English as a Second Language training

  Access to computers, printers & job resources

 Computer skills building

  Occupational job training


Youth Services




3. What is your religion? (OPTIONAL) NOTE:  This question is asked for statistical purposes only.  Your answer will NOT affect your eligibility for JVS services.

Buddhist                   Jewish

 None                    Decline to state

Christian                   Moslem

 Other (specify)

Do you require any special accommodations? (Please specify and submit all accomodation requests at least 5 business days before the day of the workshop)

5. Please do not add me to your mailing list.