Self-Referral Form

This page is specific to individuals facing economic hardship, needing support.

To refer yourself or someone else into the program, you may call 412-963-6311 or email dpomaybo@na-WIN.com, fax this form below to the number above or submit online.

If you are interested in WIN or GIN Membership, please click here.  DO NOT fill out this application.

TO PARTICIPATE IN THE WIN WORFORCE DEVELOPMENT PROGRAM, PLEASE FILL OUT THIS FORM