Copy of Tri-Parish Works - Workforce Development Training Assistance Pre-screening

Eligibility Pre-screening

ST. TAMMANY, ST. BERNARD, PLAQUEMINES PARISH RESIDENTS ONLY

Outside these three parishes, please contact your local workforce center.

Many individuals that are seeking employment and training in a high-demand occupation may qualify as eligible for assistance from Tri-Parish Works. Your answers to these questions will help us determine if you meet the initial criteria for assistance, including certain funding assistance, which may include, tuition, supplies, tools, fees, child care, or transportation, etc.

UPDATE July 2022: Due to recent funding cuts, funding assistance will be approved through a priority of service protocol. Individuals will be evaluated on the basis of need and availability of funds. Funding will be capped not to exceed $5,000 per individual. These funding cuts do not affect any other services offered by Tri-Parish Works, including job search assistance, career counseling, job development, resume review, and interview prep.

Please complete all questions accurately so that we may assess your situation and provide the most assistance. If you are eligible you will be contacted to provide documentation to verify your eligibility.

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* 1. Please provide the following contact information

First Name *

Last Name *

Last 4 of your SSN (Optional)

Parish you where you currently live (St. Tammany, St. Bernard, Plaquemines only): *

Email Address that is checked often: *

Phone Number:

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* 2. If you have already decided on a particular school, please tell us which one or if uncertain, select, other.

Delgado Community College

Delta

MedCerts

Northshore Technical Community College

Nunez Community College

Coastal Truck Driving

Other, including undecided (please specify below)

Please name Other

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* 3. Do you know what training program(s) you are interested? What is the name of the training, degree or certificate program?

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* 4. The purpose of WIOA funding is to help you overcome barriers that might keep you from completing training. What type of financial assistance are you in most need of:

Tuition Assistance

Supplies, Tools, or Uniforms

Transportation

Childcare

Other (please specify)

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* 5. What is your current employment situation?

Unemployed (Not working)

Part-Time Employed (Less than 35 hrs/week)

Full-Time Employed (35+ hrs/week)

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* 6. If you are currently working

What is your job title?

How many average hours/week?

Current hourly rate of pay?

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* 7. Please answer the following questions to assist us in determining your eligibility as a "dislocated worker" Please answer each question carefully and accurately.

	Yes	No
Are you a recently separated veteran (last 36 months)	Are you a recently separated veteran (last 36 months) Yes	Are you a recently separated veteran (last 36 months) No
Are you the surviving spouse of a veteran who is eligible for VA benefits?	Are you the surviving spouse of a veteran who is eligible for VA benefits? Yes	Are you the surviving spouse of a veteran who is eligible for VA benefits? No
Are you receiving or have you exhausted unemployment benefits?	Are you receiving or have you exhausted unemployment benefits? Yes	Are you receiving or have you exhausted unemployment benefits? No
Were you laid off in the last 7 years and now making less wages than before?	Were you laid off in the last 7 years and now making less wages than before? Yes	Were you laid off in the last 7 years and now making less wages than before? No
Did your previous employer close or go out of business?	Did your previous employer close or go out of business? Yes	Did your previous employer close or go out of business? No
Did you work less than 20 hours a week in your last job?	Did you work less than 20 hours a week in your last job? Yes	Did you work less than 20 hours a week in your last job? No
Was your last employer a temporary employment agency?	Was your last employer a temporary employment agency? Yes	Was your last employer a temporary employment agency? No
Are you not likely to return to your previous occupation with the skills you currently have?	Are you not likely to return to your previous occupation with the skills you currently have? Yes	Are you not likely to return to your previous occupation with the skills you currently have? No
Were you self-employed, but the economy or a natural disaster has put you out of business?	Were you self-employed, but the economy or a natural disaster has put you out of business? Yes	Were you self-employed, but the economy or a natural disaster has put you out of business? No
Have you been dependent on the income of another family member and are no longer supported by that income; and are unemployed or underemployed and experiencing difficulty in obtaining employment?	Have you been dependent on the income of another family member and are no longer supported by that income; and are unemployed or underemployed and experiencing difficulty in obtaining employment? Yes	Have you been dependent on the income of another family member and are no longer supported by that income; and are unemployed or underemployed and experiencing difficulty in obtaining employment? No
Since the January 2020 have you been unemployed for more than 12 consecutive weeks?	Since the January 2020 have you been unemployed for more than 12 consecutive weeks? Yes	Since the January 2020 have you been unemployed for more than 12 consecutive weeks? No

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* 8. Please complete the following for additional eligibility consideration:

	Yes	No
Do you or someone in your household receive Food Stamps (SNAP):	Do you or someone in your household receive Food Stamps (SNAP): Yes	Do you or someone in your household receive Food Stamps (SNAP): No
Do you or someone in your household receive Welfare Assistance (TANF):	Do you or someone in your household receive Welfare Assistance (TANF): Yes	Do you or someone in your household receive Welfare Assistance (TANF): No
Are you between the ages of 16-24:	Are you between the ages of 16-24: Yes	Are you between the ages of 16-24: No

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* 9. Please complete the following for additional eligibility consideration:

Number of immediate family members in household (including yourself):

Approximate household gross income for the past 6 months (includes all contributing family members of the household) Please only enter numbers, do not enter any symbols ( $ , . )

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* 10. I certify that the information provided is true and accurate to the best of my knowledge. Please enter today's date

Today's date:

Date

Thank you for completing the pre-eligibility application. If you are located in St. Tammany, St. Bernard, or Plaquemines Parish you will be contacted by a Career Specialist to determine eligibility, complete your application, and provide the following documentation:

Valid Driver's License or State ID
Social Security Card
Employment history, including dates of employment
If a male over the age of 18, Selective Service verification
If a veteran, DD-214
Additional documentation to verify eligibility will also be requested

Please allow 2-3 business days for a response from a Career Specialist as this is a customized process to meet each person's individual needs. If you do not receive a response within 5 days, please notify us at info@triparishworks.net If you are a resident outside of our service area, we encourage you to contact your local American Job Center. Don't know who that is? Visit www.louisianaworks.net

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* 11. Remember to register or update your information in HiRE at www.Louisianaworks.net, including your employment history. The more updated and complete this information is, the more quickly we can process your eligibility determination. Even if you are not eligible, registering in HiRE will give you a head start in finding that future career that you have always wanted.

Please tell us about your career interests to help us better understand your needs. Also, feel free to let us know if you have any questions or concerns that you would like to have answered by a TPW staff member