Referral – Unleash Your Abilities Inc.

Vocational Rehabilitation Career Camp (VRCC)

Vocational Rehabilitation Career Camps (VRCCs) provide students with valuable opportunities to prepare for careers in the modern workforce. Participants engage in diverse Pre-Employment Transition Services (Pre-ETS) that allow them to explore career options and discover pathways available after high school. Vocational Rehabilitation collaborates with approved VR Career Camp providers to offer tailored Career Camp experiences through a variety of Pre-ETS activities. These Career Camps are available during any period when students have at least three consecutive days off from school, such as summer break, winter recess, spring break, and other extended holidays.

SUBMIT REFERRAL FORM ONLINE

First Name

Last Name

Date Of Birth

Gender

Disability Documentation

Home Address

City

Zip Code

County

Phone Number

Name Of School

Parent/Guardian Information (if applicable) Name

Parent Home Phone

Parent Cell

Parent Email

Referring Agency

Position

Referring Agency Email

Ref Agency Telephone

Do you require an American Sign Language interpreter

Do you require an assisted listening device

Do you require translated documents?

Do you require a foreign language interpreter?

Do you require any other accomodation for your impairment?

If yes, please explain

Job Exploration Counseling (includes discussions on the student's vocational interests, the labor market, and identification of career pathways)

Work Reading Training ( A 20 hour course that focuses on empoyability and work readiness skills)

Self-Advocacy Training (A course that teaches students how to speak up for themselves and make decisions about their own lives)

Postsecondary Educational Counseling (provides an awareness of post-secondary career pathway options with job and career information) * Service is not currently available

Work-Based Learning Experiences (includes hands on training for employability skills; may be paid or non-paid)

I understand that through Vocational Rehabilitation, I will be offered limited Pre-Employment Transition Services that can help me explore, prepare for, and make informed career-based decisions. I understand that I must be anactive participant in the services I choose to achieve my transition goals.

Date

By Signing this Pre-ETS Referral, I give Unleash Your Abilities Inc, permission to submit this Pre-ETS Referral to VR. I understand I will be contacted by VR Staff to set up an initial meeting and acknowledge that my participation is required if my child is under 18 or if I am his/her Guardian.

Date

Referral Staff

Signature

Date

Name Of Person Submitting the Pre-ETS Referral to VR:

Phone Number If Different

Vocational Rehabilitation Career Camp (VRCC)

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