Get Customer Application (pdf) - Florida Division Of Vocational ...

Filling out the Customer Application for Vocational Rehabilitation services is a crucial step in receiving assistance for securing or retaining employment. This guide will provide you with clear instructions to complete the form efficiently and accurately online.

Follow the steps to complete your application online.

1. Click the ‘Get Form’ button to access the Customer Application form. This will allow you to open the document for editing.
2. Begin filling out the application by providing your personal information. Start with your name, social security number, and the date of your request.
3. Enter your address, including city, state, and zip code, along with your date of birth. Indicate your sex and marital status.
4. Provide a reliable telephone number or email address where you can be contacted. Make sure to include a contact person and their telephone number if needed.
5. Describe the impairment that affects your ability to work and indicate any specific accommodations you may require, such as an interpreter or assistive equipment.
6. If you are being referred by an agency or individual, fill in their details, including name, address, and contact number.
7. Review the acknowledgement statement regarding your understanding of the application process and services. Sign and date the application.
8. Finally, save your completed application. You may choose to download, print, or share the form as needed.

Complete your application online to take the first step towards receiving Vocational Rehabilitation services.