Recruit Disability Form

RecruitDisability.com is the JOB SEEKER service of The Sierra Group's Candidate Sourcing Division.

If you are a person with a disability looking for work, please fill out our form because our network of employers proactively hire qualified applicants with disabilities and veterans!

If you are a business looking to diversify your workforce by hiring people with disabilities, including veterans, we can help you meet these goals - visit www.thesierragroup.com - Candidate Sourcing Division.

For information, call (800) 973-7687

JOB SEEKERS - Register Today!

Resumes can be FAXED to (610) 992-0947 – Attn. Candidate Sourcing

or click here to register and upload your resume.

Click here to view some of our HOT JOBS

photo of Connie Whalen Connie Whalen is Sierra’s Director of Strategic Sourcing. She brings the contacts and skills from a twenty year career with the United States Navy to help job seekers with disabilities find competitive employment. Connie medically retired from the Navy following a highly decorated career as a Recruiter for Navy Special Programs. Her accomplishments during her career include 3 Navy Achievement Medals, recognition as the National Medical Recruiter of the year in both 2003 and 2004, and she is a veteran of two wars - Desert Storm and Operation Iraqi Freedom.

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Candidate Intake Form

Please fill out the form below.

Read our privacy policy to see how we handle the personal information you give to us.

Please note that some fields are required. Allow JavaScript and pop-ups.

First Name (Required)
Last Name (Required)
Home Address (Required)
City (Required)
County
State/Province (Required)
Zip (Required)
Best telephone number
to reach you (Required)
Alternative telephone
number (optional)
Email (Required)
Are you currently employed?
(Yes/No) (Required)

Are you a person with a disability?
(Yes/No) NOTE: Our Job Board is
funded by organizations with a
commitment to driving up employment
for Americans with disabilities,
including disabled veterans. You
must answer yes to this question
in order to proceed. (Required)

What is your highest level of education?
(Required)

What year did you achieve this educational
milestone? (mm/yy) (Required)

Are you a Veteran? (Required)

If you are a service disabled veteran, what
is your % disability rating? DOD % disability rating

VA % disability rating

Have you ever been employed?
(Yes/No) (Required)

If yes: What was your last job title?
(put none if you have never been
employed) (Required)

What was your rate of pay at your last job?
(put none if you have never been
employed) (Required)

Are you looking for Full time or Part time
employment? (Required)

If part time, please indicate how many hours
per week you are willing to work?
(put not applicable if you are seeking full
time employment) (Required)

Do you have a valid driver's license and/or access to reliable
transportation to and from work? (Required)

What is your career objective? i.es: (Electrical engineer,
office assistant, outside sales, etc.) (Required)

Are you interested in any of these fields?
(check all that apply) (Required)
Call Center or Customer Service Work:
Healthcare or Allied Professions:
Information Technology:
Marketing or Sales:
Administrative/Bookkeeping/Accounting:
Dispatch:
Production:
Social Services:
Paralegal/Lawyer:
Engineering:
Equipment Operation or Driving:
Home based work opportunities:
If other, please specify:

What annual salary or hourly wage are you willing
to accept? (Required)

Are you willing to relocate? (Required)
What is the nature of your disability?
Are you an assistive technology user?
If yes, please describe.
Are you currently receiving disability
benefits checks? If yes, please identify all that apply:
SSI:
SSDI:
VA Benefits:
Long Term Disability Benefits:
Workers Compensation Benefits:
Other:

Are you working with a
Vocational Rehabilitation Job Coach,
Long-Term Disability Carrier, or the VA
regarding job search? (Yes/No)

If yes, would you like us to include your
Voc Rehab or Agency Service provider in
our collaborative? If so, please list contact
information here.

Is there any additional information
that you would like to share with
the team at The Sierra Group?
Please cut and paste your resume into the text box below.

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