Enrollment Application

We greatly appreciate your interest in our organization and assure you that all applicants are considered for all services without regarding to race, color, sex, religion, national origin, disability, veteran status, and any other protected category under federal, state, or local law. Please note this application must be completed in its entirety and signed to be considered as a candidate for services. Information submitted on this application is subject to verification. Also note: All new candidates are subject to drug/ alcohol testing prior to receiving any assistance or while receiving assistance.

*SSN may be requested to complete a background check if applicable. In addition to filling out this application, ALL applicants are required to submit a list of THREE references. Please submit all supplemental information to us by email at If you are unable to print out the form or need any accommodations, please contact us.

If you are under 18, the next three questions are REQUIRED for you.
If you answer YES to this question, the next three questions are REQUIRED for you.
If you resided at your current address for less than one year, please provide you previous address:
REQUIRED if you've resided at your current address for less than one year.
REQUIRED if you are currently employed.
REQUIRED if you are currently employed.
(Note: answering YES will NOT disqualify you from consideration).
REQUIRED if you answered YES to the previous question.
Select ALL that apply.
Please provided dates, addresses, and degrees / certifications for ALL educational institutions you've attended.
REQUIRED if you answered YES to the previous question. Please provide the address and the degree program you're enrolled in.
If none, type N/A.
If none, type N/A.
This should be a motivational statement of 50-200 words detailing your interest and expectations.
I hereby affirm that I have read the foregoing questions and that my answers to them are true and correct and that I have not misrepresented or withheld any information. I understand that falsification of this information may be cause for immediate refusal of services. I further acknowledge that my participation in the program may be terminated without prior notice at any time by the organization or by me. I also understand that my participation is at will. This means that I am free to terminate my agreement at any time, for any reason, and the organization has the same right. I understand that any offer of or the ongoing status of my assistance may be contingent upon a criminal background investigation (including both state and national) which may be completed at any time during the agreement with Bro2Go LLC. I hereby authorize all references and former employers listed on my application to give the organization any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise. I hereby release all parties, including agents, from any claims, causes of action, or liability from damages that may or could result from furnishing such information to the organization or as a result of information obtained through a background investigation or drug screening.