Career Development Application Form

Thank you for your interest in our career development program. One of our first steps is a background check to identify jobs and career fields that best suit your eligibility. Please fill out the form below to authorize your background check and and identify your interests. If you have any questions, please email Morgan Villegas:

Are you currently enrolled in school?
Are you enrolled in the Summit County Public Health | Healthy Moms, Healthy Babies Program?*
Is childcare a major barrier for you?
Is transportation a major barrier for you?
Are you willing to commit to our 5 week program, Tuesday through Friday from 10AM-2PM, to help you establish the next steps in your career search?
Authorization for Background Check

I hereby certify that the information provided is complete and accurate to the best of my knowledge. I also authorize The Well CDC and/or its representatives to verify income, employment; and conduct credit and background checks.

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