(example: Goodwill, Vocational Rehabilitation, etc.)
Please provide contact information for 2 other individuals who can always contact you. In the case that we cannot reach you, we may contact them in our attempts to contact you.
This applies only to males born after 1960.
(When would you like to be employed?)
Complete the following employment history record starting with the most recent. Include your full work history for the last 10 years. Please complete all information. It is acceptable to use city and state for location.
Attach additional pages if you have had more than 6 jobs in the last 10 years.
Please complete the following information for all members in your household (including yourself).
Such as SNAP (food stamps), TANF (cash assistance), SSI (Social Security Income), SSDI (Social Security Disability Insurance), etc.
If there are more than 5 individuals in your household, please upload a document with required information for them.
Please sign and provide the date on which you are submitting this application.
By checking the "I agree" box below, you agree and acknowledge that: your application will not be signed in the sense of a traditional paper document, by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, you may still be required to provide a traditional signature at a later date.
I certify that my answers are true and complete to the best of my knowledge. I understand that false or misleading information in my application or interview may result in disqualification for financial aid consideration.
You can submit a saved copy of the Scholarship Application (Financial Aid Addendum) with this form. Please also include a copy of your training program acceptance letter, career interest inventory, and any additional information requested by Workforce Solutions staff with this application.
Applicants can complete the web-based Scholarship Application instead of submitting a copy with this form.
Auxiliary aids and services are available upon request to individuals with disabilities. Relay: 1-800-735-2989 (TTY) / 711 (Voice).
This service is funded in whole or in part with federal funds. More detailed information is located on the Public Information page on the Board’s website.
The information requested on this form is optional and is being collected for the primary purpose of reporting to federal and equal opportunity reporting agencies. While we request that you respond to each of the line items in order to complete your full application, you may choose whether or not to disclose information by leaving any questions you do not wish to answer blank.
Information contained in this survey shall be retained in such a manner as to ensure confidentiality and shall be used only for purposes of record keeping and reporting where appropriate for grant-funded programs or activities. Workforce solutions of west central texas is an equal opportunity employer/program and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, political affiliation or beliefs; or against any beneficiary of, applicant to, or participant in programs financially assisted under Title I of the workforce innovation and opportunity act, on the basis of the individual’s citizenship status or participation in any Workforce Innovation and Opportunity Act (WIOA) Title I-financially assisted program or activity.
Check all that apply.
Please check all that apply.
I certify that my answers are true and complete to the best of my knowledge.
* indicates a required field
