PRIVATE INTAKE · YOUR NEXT MOVE STARTS HERE

Tell us what you need. Not everything you survived.

This intake helps us route you toward the right 50% member access, one-on-one training or employment-readiness support.

01 · How can we reach you?

Required fields are marked with *.

First name *

Last name *

Email *

Phone

City *

State *

02 · Where are you right now?

Choose the closest answer. You may select “prefer not to say.”

Reentry stage *

How did you hear about Second Chance Circle?

03 · What do you need first?

Select every area that applies.

Employment-readiness or job-search supportDigital tools, computer or AI-skills trainingHelp starting or rebuilding a business50% access to a Lindsey Effect product50% access to an eligible Purpose Built service50% access to one-on-one training

04 · Help us understand the next move.

What are you trying to accomplish in the next 90 days? *

What experience, skills or strengths do you want us to know about?

What technology can you reliably access?

05 · Opportunity permission

You may contact me about aligned jobs, interviews, contract projects or employer introductions when available. I understand that no opportunity or placement is guaranteed.I give The Lindsey Effect permission to contact me about this intake. *

Your privacy matters. Information submitted here is used to review your eligibility and route you toward relevant Second Chance Circle support. Do not include conviction details, identification numbers, court records, medical information or other sensitive documents.