Quality Career Services

2515 Wabash Ave LL1

St. Paul, MN 55114

651-647-9322 or

1-800-761-9991

FAX: 651-647-0423

TTY: 651-646-7514

Dislocated Worker Program and

Senior Community  Service Employment Program

ENROLLMENT FORMS

Once you have completed these forms, mail them to

Quality Career Services
2515 Wabash Ave., Suite LL1
Saint Paul, MN 55114

NOTE: These are Adobe Acrobat (pdf) files. You must have Acrobat Reader installed on your computer to view them.

WORKFORCE ONE, MINN. DISLOCATED WORKER FORM:
Do not answer the shaded items.
Be sure to sign and date the form.

USE OF DATA STATEMENT:
This form describes the limitations on how we may use the information you provide.
Be sure to sign and date the form.

CONSENT TO SHARE WAGE & EMPLOYMENT INFORMATION:
This gives us permission to match wage records at the time of placement with the information that is in the Wage Detail database that is located in the Data Warehouse. This is sometimes helpful if for some reason we are unable to locate you.
Be sure to sign and date the form.

EMPLOYABILITY PLAN:
This form asks for general information, education, licenses you may have, and employment history. Read the follow-up agreement and provide names of 2 people we can contact if we lose contact with you.
Be sure to sign and date the form.

VERIFICATION FORM:
This is a 3 part form. It asks for self-verification of employment. It asks for your signature verifying that you have received the WIA Title I Complaint Procedure, which is the next form on this list.

NOTE: DO NOT MAIL WIA TITLE I COMPLAINT PROCEDURE BACK TO US. Keep it for future reference:

WIA TITLE I COMPLAINT PROCEDURE:
This describes the procedure by which you can resolve a complaint about the dislocated worker program.

NETWORKING CALENDAR

COMPUTER LAB