Tri-Parish Works - On-the-Job Training Candidate Pre-screening

Eligibility Pre-screening

Most newly hired people are trained on-the-job. The On-the-Job Training (OJT) program is funding to help offset the employer's cost of that training. The benefit to individuals is that they can be considered for more positions when they don't necessarily have all of the skills needed to be 100% productive on day one. Evidence also shows individuals that participate in the OJT program are more likely to retain their job longer and earn a higher wage.

On-the-Job Training is coordinated and funded by the Tri-Parish Works and the local Workforce Development Board.

Your answers to these questions will help us determine if you meet initial criteria. Please complete all questions with accurate information. If you are likely to be eligible based on your answers, you will be contacted to complete an assessment and provide additional documentation to verify your eligibility.

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* 1. Please provide the following contact information

First Name *

Last Name *

Last 4 digits of social (or 0000)

Parish you where you currently live: *

Primary Phone Number: *

Alternate Phone Number:

Email Address that is checked often: *

Phone Number that is available to receive Text Message:

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* 2. Are you a Veteran or the spouse of a Veteran? (Veterans and qualified spouses receive Veteran's Priority of Service)

Yes

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* 3. Are you a recently separated veteran (last 36 months) or the surviving spouse of a veteran who is eligible for VA benefits?

Yes

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* 4. Are you between the ages of 16-24:

Yes

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* 5. Are you 49 years of age or older:

Yes

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* 6. Were you asked to complete this pre-screening application by a specific employer or are you seeking opportunities to connect with employers through the On-the-Job Training program?

Referred by a specific employer

Seeking opportunities to connect to On-the-Job opportunities with employers

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* 7. If referred by an employer, please name of the employer that has requested you to be assessed for the On-the-Job Training (OJT) eligibility. If you were not referred by an employer, please tell us how you learned about OJT.

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* 8. What is the title of the position that you are being considered for at the company/organization? If you were not referred by an employer, tell us what kinds of occupation(s) are you most interested?

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* 9. If known, what is your anticipated start date? If you were not referred by an employer, please skip this question.

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* 10. What is your current employment situation?

I am not currently working

I am currently working full-time (more than 30 hrs a week)

I am currently working part-time

I work very sporadically (less than 120 hours on average per month)

If you are currently working, what is your hourly rate of pay?

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* 11. 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 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 or upgrading 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 or upgrading 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 or upgrading employment? No
Would you estimate that in the last 5 years you have been unemployed for 27 weeks or more in total? Not required to be 27 consecutive weeks. Lost employment due to COVID or recent hurricanes?	Would you estimate that in the last 5 years you have been unemployed for 27 weeks or more in total? Not required to be 27 consecutive weeks. Lost employment due to COVID or recent hurricanes? Yes	Would you estimate that in the last 5 years you have been unemployed for 27 weeks or more in total? Not required to be 27 consecutive weeks. Lost employment due to COVID or recent hurricanes? No
Do you have a high school diploma or it's equivalent?	Do you have a high school diploma or it's equivalent? Yes	Do you have a high school diploma or it's equivalent? No

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* 12. If you indicated that you are a recently separated veteran, please indicate your date of separation.

Date of separation:

Date

Thank you for completing the OJT pre-eligibility application. If you are determined eligible you will be contacted by the local Tri-Parish Works Center to 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

Our workforce development professionals will assess your skills and experience in relation to the position to determine if OJT is appropriate. This is done in-person in a one-on-one format.

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* 13. What is your approximate household income? Please only enter numbers, do not enter symbols ( $ , . )

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* 14. Number of family members in household (including yourself):

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* 15. Please complete the following for additional eligibility consideration. This information remains confidential and is not shared with any employer.

	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

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* 16. Ways to expedite the process:

Please register or update your information in HiRE at www.louisianaworks.net. The more updated and complete this information is, the more quickly we can process your eligibility determination. Even if you are not eligible, having an account in HiRE provides you access to great resources even beyond job postings.

Please let us know to let us know if you have any questions or concerns that you would like to have answered by a staff member of Tri-Parish Works.

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* 17. 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