Career Dislocated Workers Grant Guide

Written Customer Self-Attestation is used to verify eligibility items that, in some case, are not verifiable or may cause undue hardship for individuals to obtain. At a minimum, all self-attestation forms must include: 1. The applicant’s full name 2. Clear statements of the issue being documented

3. The applicant’s signature 4. Case manager’s signature

Signatures for the CAREER NDWG Application, Consent to Release Information, and Written Customer Self-Attestations may be captured electronically with signature pads, Docusign, Adobe, and various other software.

1.6 PARTICIPANT FILE DOCUMENTATION

The participant file (hard copy or electronic) must contain the following documentation at program enrollment; applicable forms must be signed and dated on or before the date of program enrollment. Paper forms must be uploaded into AGS Prime. • A complete paper CAREER NDWG Registration Form. • Documentation validating the participant’s CAREER NDWG Dislocated Worker program eligibility. • Documentation of GUILFORD COUNTY residency. • Comprehensive Assessment. • Individual Employment Plan (IEP). • Equal Opportunity-Notice of Right to File a Discrimination Complaint. • Authorization to Release Confidential Information. • Employment status at program enrollment. • Veteran status at program enrollment (if applicable).

• Date of first qualifying service that triggers participation, verified with a case note. • Date of program enrollment, verified with a case note and the date of the application.

All case notes must be in compliance with GuilfordWorks WDB Case Note Policy.

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