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Jewish Family and Children’s Service of Minnesota
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Visit the Career Services page

Vocational Rehabilitation Program Application

Please answer the questions below so we can determine which of our Vocational Rehabilitation programs is the best fit. The information you provide will help us assess your eligibility. If you are eligible, we will follow up regarding next steps. *All fields are required. If a field does not apply to you, enter N/A.

Full Legal Name(Required)
Address(Required)

Diagnostic Information:

If you do not have a physical, cognitive, or mental health condition, write “N/A”
Can you provide documentation of the condition upon intake into the program?(Required)
Are you receiving waivered service(s)?(Required)

Employment Information:

If you are not currently employed, write “Not Employed”

Functional Limitations:

Communication(Required)
Limited ability to give and receive information through words or concepts via reading, writing, speaking, listening, or other adaptive methods.
Mobility(Required)
Limitations in physical and/or psychological ability to move from place to place.
Interpersonal Skills(Required)
Limited ability to establish and maintain relationships.
Self-Care(Required)
Limited ability to perform the skills needed to manage one’s self or living environment.
Self-Direction(Required)
Limited ability to independently plan, initiate, organize, or carry out tasks or problem-solve.
Work Skills(Required)
Limitations in the ability to do specific tasks required to carry out job functions.
Work Tolerance(Required)
Limitation in capacity and/or endurance to perform jobs requiring various levels of physical and/or psychological demands.
Acknowledgment & Signature(Required)
I understand that JFCS will follow up for verification. If I do not meet eligibility criteria or are unable to provide documentation, I may not be enrolled in a program.

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Contact Us

Jewish Family and Children’s Service of Minnesota

5905 Golden Valley Rd, Golden Valley, MN 55422

952-546-0616 | 952-593-1778 fax

Copyright © 2026 | All Rights Reserved

JFCS is committed to the inclusion of all people.

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PRIVACY
  • About Us
    • About JFCS
    • Board of Directors
    • Leadership Team
    • JFCS & JFS Unite
    • Careers at JFCS
    • Accreditations & Partners
    • Client Policies
    • Strategic Plan
  • Programs & Services
    • Career Services
      • Dislocated Worker
      • Ed2Go
      • IT Pathways Training
      • Minnesota Family Investment Program
      • Project EM
      • Vocational Rehab
    • Community Engagement
      • Hag Sameach
      • J-Pride
      • The Jewish Community Inclusion Program for People with Disabilities
      • Jewish Grandparent Community
      • Little Free Library
      • NextGen
      • PJ Library / PJ Our Way
      • Shalom Baby
      • Women Connect
    • Education & Learning
      • Annual Mental Health Education Conference
      • “Keeping the Spirit Alive” Caregivers Conference
      • ParentChild+
      • Professional and Community Education
    • Essential Services
      • Academic Scholarships
      • Camp Scholarships
      • Food Security Initiatives
      • Jewish Free Loan Program (JFLP)
    • Mental Health & Support
      • Recovery and Prevention Services
      • Adult Mental Health Case Management
      • Counseling
      • Discernment Counseling
      • Prepare/Enrich
      • Support Groups
      • Waiver Case Management
      • Intake and Resource Connection (IRC)
    • Senior & Caregiver Services
      • Accompanied Transportation
      • Bonnie Care – Medical Care Management
      • Care Planning Consultation
      • Case Management
      • Dementia Caregiver Connect
      • Dementia Friends
      • Holocaust Survivor Support Services
      • Jacob Garber Transportation Servies
      • JFCS Memory Café
      • Kosher Meals on Wheels
      • Powerful Tools for Caregivers
      • Senior Companions
      • Shopping Services
    • Patient Portal
  • Volunteer
    • Volunteering
  • Calendar of Events
    • Calendar
    • Annual Benefit
    • Mental Health Education Conference
    • Keeping the Spirit Alive
  • News & Blog
    • JFCS Blog
    • Newsletters
    • Financial Information
  • Ways To Give
    • Tribute Cards
    • General and Fund Specified Contributions
    • Give 2026 Campaign
    • Innovation Fund
    • Hag Sameach
    • Annual Mental Health Education Conference
    • Keeping the Spirit Alive
    • NextGen
    • Endowment and Legacy Giving
    • Payment Methods
  • Contact Us
    • Contact Information