Dress for Success Houston Referral Form

Since 1998, DFS Houston has been dedicated to our mission of empowering women to achieve economic independence by providing a network of support, professional attire, and development tools to help women thrive in work and life.

Agency Eligibility

Over 18 years old

Do you identify as a woman?

Do you speak and understand English?

All Programs are led by volunteers in English.

Employment Status

Current Employment Status

Referral Type

Referral

Did someone at an organization refer you to us?

Have you recently started a new job or received a promotion?

Do you have a scheduled interview, job fair, or college graduation?

Are you unemployed or underemployed and actively job searching?

You'll qualify for professional attire by attending Job Search workshops

Are you a woman veteran seeking a network of other women veterans?

Referral Program

Job Search – a woman who is unemployed or underemployed and actively Job Searching who does not have an upcoming interview or job fair.

Interview Suiting – a woman who has an upcoming interview, job fair or college graduation

Employment Suiting – a woman who has recently started a new job or received a promotion

Women Veteran's Program – a woman veteran who is seeking a network of other women veterans

Contact Information

First Name

Middle Initial

Preferred Name

Last Name

Date of Birth

Phone Number

Zip Code

Interview Suiting - Details

Date of Interview/Job Fair/Graduation

Potential Employer

Job Fair Name

School/Graduating Program

Employment Suiting - Details

New Employer

Start Date

Job Title

Schedule Type

Industry

Field

Job Type

Salary Range

Hourly Rate

exact dollar amount i.e. 12.00, not a range

Referral Information

Member Organization

Agency Contact First Name

Agency Contact Last Name

Agency Contact Phone Number

Agency Contact Email

Demographics

This data is collected to help us understand the communities we serve. Reports contain collective data; individual identifying data is not shared. Your responses do not impact your ability to receive services.

Ethnicity

Marital Status

Education Completed

Are you a Veteran/Active Duty

Branch of Service

How many children do you have?

# of Household Children Under 18

Additional Demographics

What best describes your housing situation?

What is your primary mode of transportation?

Is your current mode of transportation reliable?

Do you currently receive public assistance (e.g., SNAP, public housing)?

Have you every experienced Domestic Violence?

Have you had to transition from prison/jail ?

Have you ever owned a suit before?

Do you need Special Accommodations?

*- required

Type of Accommodation Needed

How you found us

How did you hear about us?

More details (name of person/organization/event)

We'd like to know who or how by name

For Client - Agency Communication

Do you agree to receive text updates from DFS Houston regarding program services, reminders, and agency updates?

YesNo

Contact Information