Northwest Workforce Investment Board
Becky Steele: Executive Director
912 Main Street * Trenton, MO 64683 * 800-794-3535 * 660-359-3622 * 660-359-3082 Fax
 
Serving 18 counties in Northwest Missouri
 Andrew, Atchison, Buchanan, Caldwell, Clinton, Dekalb, Daviess, Gentry, Grundy, Harrison, Holt, Linn, Livingston, Mercer, Nodaway, Putnam, Sullivan, Worth

"A qualified person for every job; a quality job for every person"

Through partnership with each local community, it is our vision that every employer will maintain a qualified, productive workforce; and that every job-seeker will have education and training opportunities, throughout their lifetime, which lead to a lasting, living-wage job commensurate with their abilities and goals.

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WIA Adult / Dislocated Worker Forms

  1. WIA Adult file checklist

  2. WIA DW cat A file checklist ~ Permanent Layoff or Termination

  3. WIA DW cat B file checklist ~ Plant Closure or Substantial Layoff

  4. WIA DW cat C file checklist ~ Dislocated Self Employed

  5. WIA DW cat D file checklist~ Displaced Homemaker

  6. Eligibility Attestation

  7. Off-Site Data Collection Form (for off-site intake only)

  8. Complaint/Grievance Procedure (Guide)

  9. Release of Information Authorization

  10. Commitment of Understanding

  11.  Income Verification Form

  12. Income Calculation Procedure

  13. Applicant Statement

  14. Individual Employment Plan (IEP) (Not In Binder, see Toolbox

  15.  Needs Related Payment Policy, also reference Adult/Dislocated Worker Scope of Work page 16 C. Needs Related Payments

  16. Needs Related Payment Determination for DW Form

  17. Needs Related Payment Determination for Adults & DW form

  18. Supportive Services Policy

  19. Summary Sheet of Funding Resources

  20. Childcare Verification

  21. I-9, Press Release on Dept. of Homeland Security Update to 1-9, About the I-9 Form, FAQ’s

  22. ITA Administrative Procedure

  23. DESE-6, Individual Training/Referral Account

  24. Title 1 Training Site Plan

  25. DESE Monthly Progress and Attendance Report

  26. NW Region On-the-Job (OJT) Policy

  27. WIA Regulation References Relevant to OJT

  28. OJT Training Site Plan

  29. DWD OJT Monthly Progress Report/Invoice

  30. Certificate of Skill Completion

  31. OJT Employment Statement

  32. OJT Payroll Monitoring Report

  33. Union Concurrence

  34. Paid Work Experience Training Site Plan

  35. Reimbursement Voucher—Participant

  36. Reimbursement Voucher—Employer

  37. Referral Form

  38. Response to WIA Title 1 Service Provider’s Request for Employment/Wage Information        

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Last modified: August 19,  2008