Veterans
Resources
Center

Pre-Employment Questionnaire

Pre-Employment Questionnaire

This form is submitted to Veterans Resource Center of Dallas' Employment team as part of the onboardng process for the Veterans Employment Program.

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This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Texas County of Residence(Required)

Date Of Birth(Required)

Marital Status(Required)

Criminal History(Required)

If you have any warrants or felonies on your record, please describe.

Military Affiliation(Required)

Veteran

Dependent

Surviving Spouse

Gender(Required)

Male

Female

Race(Required)

Ethnicity(Required)

Hispanic or Latino

Not Hispanic or Latino

Military History

Have You Ever Served in The U.S. Armed Forces?(Required)

Yes

No

Branch of Service(Required)

Rank(Required)

Discharge Date(Required)

Discharge Status(Required)

Employment

Type of Employment Desired(Required)

Currently Employed?(Required)

Yes

No

May We Contact Your Current Employer?(Required)

Yes

No

Special Training(Required)

Education History

High School Name and City(Required)

Graduated High School?(Required)

Yes

No

Year Graduated High School(Required)

College Name and City(Required)

College Subject Studied(Required)

Degree?(Required)

Yes

No

Years Attended College(Required)

Degree(Required)

Trade, Business, or Correspondence School?(Required)

Willing To Relocate?(Required)

Yes

No

Bilingual?(Required)

Yes

No

Do You Have Transportation?(Required)

Yes

No

Currently Receiving Unemployment Compensation?(Required)

Yes

No

Are You Interested In Taking An Interview Skills Class?(Required)

Yes

No

Additional Information(Required)

Veteran Status Documentation Required(Required)

I understand I must reply to the confirmation email with a scan of my veteran ID to be considered for services.

Acceptable forms of Veteran Status Documentation: VA ID, Military ID, Texas Driver's License with Veteran Status Designation, or Scanned DD-214

Signature

Enter your name here to confirm this information is true and correct. You MUST reply to the confirmation email with your veteran status documentation to be considered for services. Services are received at no cost.

Retype Your Name(Required)

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The Veterans Resource Center is operated by Homeless Veterans Services of Dallas, a non-profit organization that serves veterans only.

A veteran ID or proof of military service (Form DD-214) is required to access services.

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4900 S. Lancaster Road | Dallas, Texas 75216
(214) 372-8822 | ken@vrcdallas.org

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