1. RESEA - Intake

Re-Employment Services and Eligibility Assessment (RESEA) Program

Intake (INT) Form


Please complete this form to begin your participation in the RESEA program.

WD-49

Participant Details

Do you consent to receive SMS notifications? Check 'No' if unsure or landline
Were you assigned male at birth and born on or after January 1, 1960?
Did you register for Selective Service between the ages of 18 – 26? More information about Selective Service can be found at www.sss.gov

Click on the link and follow the instructions to verify your Selective Service number. Enter your Selective Service number in the box. If you are not registered for Selective Service and you are between the ages of 18-26, please register on the website and provide your Selective Service number in the box. If you are not registered for Selective Service and are over 26 years old, click NO above.

www.sss.gov/verify

Participant Employment Status