Green River Area Development District Application for Work-Based Learning and Career Services

Transcription

1 Green River Area Development District Application for Work-Based Learning and Career Services GRADD-WIOA.01 WORKFORCE INNOVATION AND OPPORTUNITY ACT TRADE ADJUSTMENT ASSISTANCE Name: SS#: Address: Phone: Birthdate: Age: Date: Office Use Only Date Received: Service Requested: The Workforce Innovation and Opportunity Act (WIOA) and the Trade Adjustment Assistance (TAA) are federal legislation established to provide services to individuals to enhance the development of occupational skills and gain employment. Individuals can utilize their Kentucky Career Center to review job openings in the area, prepare a resume, search for jobs on the internet, find labor market information, review job search handbooks and receive personal assistance from staff as needed. The Green River Area Development District (GRADD) Workforce Department provides job search assistance and federal funding for short-term pre-vocational services through the WIOA and TAA. Short-term prevocational services include development of learning, communication and interviewing skills, punctuality, personal maintenance skills, and professional conduct to prepare individuals for unsubsidized employment or training, in some instances pre-apprenticeship programs may be considered. GRADD also provides financial assistance for individuals who have scheduled job interviews 100 miles or more from home and relocation assistance for those needing to move in order to begin a new job. To receive financial assistance, you must be determined eligible for the program. WIOA assistance is not an entitlement program. Eligibility is determined on an individual basis by local requirements and guidelines of the Act. If you qualify for services, there is no guarantee you will receive any financial assistance. To apply for the GRADD-WIOA program, read the instructions on the following page thoroughly and provide all information that is requested. You may utilize your local Kentucky Career Center for job registration, resume assistance or other job search information. No funding has been approved at this point. You will be notified when/if you have been officially approved.

2 INSTRUCTIONS TO APPLY FOR PROGRAM Please make sure to read each carefully and provide all necessary information requested. All steps must be completed and information attached before the application can be reviewed. 1) Complete each section of the application. Incomplete applications will be returned to you. 2) Attach a resume indicating your current and/or previous employers and job skills. Resume assistance is available at your local Kentucky Career Center. 3) Register in Focus Career. This allows you to be matched to job openings based on your skills and experience. You are not required to take jobs referred to you; however you must be registered to be considered for the program. You can register online at (select create account one the right side of the screen) or visit your local Kentucky Career Center to register. 4) If male and were born on or after January 1, 1960, please provide a print out of your Selective Service number. You can obtain this by going to and following instructions. If you are requesting financial assistance, you must be determined eligible for WIOA program before attending training, traveling to interviews, or relocating. Last grade completed: EDUCATION: High School Diploma GED Date Received: Associates Bachelors Date Received: Major: Issuing Institution: Certificate/License: Issue Date: Issuing Organization: State: Currently Attending School: Yes No Date Began: School: MILITARY SERVICE: Veteran Status: Yes No Dates: Are you the spouse of a Veteran? Yes No Do you have a copy of your/your spouse s DD-214? Yes No 2

3 FAMILY INFORMATION Family Size: including yourself, state the number of people in your household who are related by blood, marriage, or adoption. Number of dependents who are less than 18 years of age: Are you a member of a family receiving Food Stamps or TANF? Yes No If you do not receive food stamps or TANF, record your approximate household income for the past six months: $ Please indicate the members of your household (Including yourself): Name Relation Birthdate PROVIDE DETAILS ABOUT YOURSELF TO THE FOLLOWING: How successful have you been in retaining employment: Occupational Strengths & Weaknesses (at least one of each): What type of employment are you seeking? Have you received assistance through GRADD before? Yes No If yes, what kind and when? 3

4 EMPLOYMENT INFORMATION Are you currently receiving OR have recently exhausted Unemployment Insurance benefits? Yes No Last 3 most recent employers: Employer: Address: City: State: First day Last day of work: (mm/dd/yyyy) of work (mm/dd/yyyy) Wage: $ per hr./yr. Job Title: Duties: Reason for leaving: Employer: Address: City: State: First day Last day of work: (mm/dd/yyyy) of work (mm/dd/yyyy) Wage: $ per hr./yr. Job Title: Duties: Reason for leaving: Employer: Address: City: State: First day Last day of work: (mm/dd/yyyy) of work (mm/dd/yyyy) Wage: $ per hr./yr. Job Title: Duties: Reason for leaving: 4

5 JOB SEARCH What type of job-search have you conducted? Employment Service Internet Search Resource Room Walk-in Applications Newspaper Other: Identify employment contacts you have made in the past six weeks. These contacts should be using your current job skills. Date Contacted Employer Position Result READ AND SIGN BELOW By signing below I understand that this employment plan will be evaluated for approval or disapproval based on the information provided. All applicants must demonstrate a need for training or assistance, a reasonable ability to complete training (if applicable), and obtain employment at a self-sustaining wage in the career field desired. Customer Signature Date 5

6 TO BE COMPLETED BY GRADD STAFF Application Completed Approved by: Referred to: Application Not Completed Date Returned to Applicant: Item(s) to be completed: Comments/Notes: NEED TO TRAIN CRITERIA Without training, is suitable employment currently available? Yes No Would the customer benefit from training and will the training ensure that Yes No the customer is completely job ready at the end of training? Is there reasonable expectation of employment upon completion? Yes No Is training reasonably available? Yes No Is the customer qualified to undertake and complete training? Yes No Is training suitable and available on the Eligible Training Provider List (ETPL), if applicable, at a reasonable cost? Yes No *All criteria must be documented Does this meet the high demand occupation requirements in our area? Yes No What is the identified key sector? WIOA/ FORMS Work-Based Learning and Career Services January