Local Directives

Number Title Effective date

New Program Completion/Outcomes Form 2020

09/01/2020
22-180

Federal and State Economic Security for All (EcSA) Exceptions
– Self Sufficiency Calendar School Funding Worksheet (PDF)

07/01/2022
22-179

Incentive Payments for State Funded EcSA Participants
– State Funded EcSA Incentives Agreement Form (Word)
– State Funded EcSA Monthly Performance Report (Word)

20 - 177 Rev 3

TAA & WIOA Dislocated Worker Co – Enrollment

09/15/2021
20-176

Protecting Personally Identifiable Information (PII)

02/01/2021
19-175 Rev 1

Measurable Skill Gains

10/15/2020
18-172 Rev 5

Dislocated Worker Eligibility (UPDATED)
– DW/NDWG Eligibility Verification Record NEW (4/2022)
– Applicant Statement Form
– WIOA Application
– Self-Attestation Form (Adult/DW)

06/01/2021
18-171 Rev 4

Individual Training Account

12/01/2022
18-170 Rev 2

Equal Opportunity Notice

02/01/2019
18-168 Rev 1

Youth Project Based Learning Incentives
– Performance Report & WBL Incentive Payment Form

03/01/2019
18-167 Rev 1

Individual Employment Plan for Adults/DWs
-IEP Worksheet (Fillable PDF)

07/10/2020
18-166

Workkeys Skills Certification

07/01/2018
18-165 Rev 3

CASAS for Basic Skills Assessment

06/01/2020
18-164 Rev 2

Follow-Up Services

06/01/2021
17-163 Rev 4

WIOA Youth Eligibility & Design Framework
– Application Packet
– Self-Attestation Form (Youth)
– Youth Verification Record NEW (2020)
– Individual Service Strategy (ISS) Form NEW (2020)

06/01/2021
17-162 Rev 3

Incumbent Worker Training (UPDATED)
– Employer Application
– Employer Invoice & Match Form (Excel)
– Employer Payroll Match Form (Word)
– Training Budget (Excel)
– Employer W-9 Form
– IWT Data Entry Instructions

06/01/2021
17-160 Rev 4

Data–Service Entry & Case Notes

02/07/2022
17-158 Rev 3

Self-Sufficiency & Underemployed

10/01/2020
17-157 Rev 4

Support Services & Needs-Based Payments (UPDATED)
– Participant Financial Analysis (Fillable) NEW 3/2022
– Request for Support Form (Word)
– Rental Assistance Invoice
– Fuel Reimbursement Form
– Childcare Assistance Invoice

06/01/2021
16-156 Rev 5

Youth Learning Incentives
– Monthly Performance Report & Incentive Payment

04/20/2022
16-150 Rev 3

Adult Eligibility and Priority
– Adult Eligibility/Priority Verification Record NEW (2020)
– Applicant Statement Form
– Priority Income Levels PY22
– WIOA Application
– Self-Attestation Form (Adult/DW)

06/15/2022
16-136 Rev 3

Youth Workbased Learning

08/01/2019
14-124 Rev 2

Dislocated Worker Internship

07/01/2019
14-123 Rev 1

Adult Work Experience/Internship
Work Maturity Evaluations for Adult/DW/Youth WEXs & Internships:
Appearance
Completing Tasks
Interpersonal
Positive Attitude
Attendance & Punctuality

02/01/2019
13-120 Rev 3

OJT Policy & Procedure

12/01/2022
12-108 Rev 2

Selective Service Registration

01/01/2023
11-97 Rev 1

ITA Tool Agreement/Request Form

01/18/2019
LOG 13-09 Rev 2

Customer Concern & Complaint Resolution
– Discrimination Complaint Form (English – Fillable)
– Discrimination Complaint Form (Spanish – Fillable)
– Program Complaint Form (English – Fillable)
– Program Complaint Form (Spanish – Fillable)

07/01/2022