Enrollment Form - U.S. Probation District of Eastern California

Eastern California Enrollment

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Required fields are marked with an asterisk (*).
Candidate Information
NOTE: This should be the address where you are or will be living when you need job leads. We will use this address for lead matching.

 

Offense Information

 

Probation Information

 

Employment Information

 

 

If yes, who is your current employer?

 

Acknowledgement of Terms

"By my signature affixed below, I authorize the U.S. Probation Eastern District California and representatives to release my employment information to The Next Step, Inc. and/or WOTC Solutions, LLC for the express purposes of providing me with access to “felon-friendly” employer leads from the CoFFE! database to assist me in finding employment despite my felony record, and to help an employer who elects to hire me obtain the tax benefits to which they are entitled for hiring me. I further agree to report any employment I obtain to the U.S. Probation Eastern District of California within 48 hours of obtaining employment."

 

 

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