Mem be r O rga ni zati on Ap plicat io n

Name of Organization: ________________________________________________________________________________

Address: _______________________________________________________ City: ____________________ Zip: _______
Telephone____________________ FAX: _______________ E-Mail: __________________________________________
Organization Contact: _________________________________________ Title: _________________________________
Executive Director: _____________________________________ E-Mail: _____________________________________
Supervisor, Job-Training Program: _____________________________ E-Mail: ______________________________

1. Your Mission Statement: __________________________________________________________________________

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2. Do you have Federal 501 (c) (3) status? _______Yes _____No Are you a government agency? ___Y
___N
3. Does your organization/agency provide vocational or job-training programs? If yes, please describe.
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4. What qualifications must your clients meet to enable them to participate in your program? (i.e. public
assistance, welfare to work, SSI, immigrant, etc.)
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5. Do your clients have any special needs that Dress for Success Austin should be aware of? If yes,
please explain: _______________________________________________________________________________________
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6. Do you provide ESL, GED or degree/certification classes? If yes, please specify.
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7. What type of job training/development does your organization provide?

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8. Do you provide industry-specific training? If yes, please explain. ____________________________________
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9. Are internships available to your clients? If yes, please specify. ____________________________________
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10. How does your agency/organization assist clients with a job search? Please describe. ______________
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11. Do you have a job-retention program? If yes, please describe. ____________________________________
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Please enclose with this application one or both: 1. Verification of your non-profit status
2. A pamphlet, brochure, etc. that describes your
program.

Return the completed application to: Judy Chambers, Executive Director

 Dress for Success Austin
701 Tillery, #11…Suite A-5
Austin, Texas 78702

The mission of Dress for Success is to promote the

economic independence of disadvantaged women
by providing professional attire, a network
of support and the career development tools to
help women thrive in work and in life.