At Referral

• Job Candidate’s Name and Phone Number

• Release of Information

Job Candidate Orientation (JC Confirms Moving Forward)

• Application (Screen shot must show the following data)

  • First, MI, Last Name

  • Address

  • Veteran Status

  • Race

  • Ethnicity

  • Phone Numbers

  • Email Address

  • Date of Birth

  • Gender

  • Living Situation

  • US Citizenship (I-9)

  • Zip Code

  • County

  • Student with a Disability

  • Monthly Public Supports

  • Medical Insurance Coverage

  • Employment Status including hours worked and wages

• Eligibility

  • Primary Impairment

  • Secondary Impairment

  • Waiting List Category (MSD, SD)

  • Date of Eligibility Determination

• Individualized Plan for Employment (IPE)

  • Most recent IPE showing ISE Technical Assistance Service as a service needed

  • Information Collection and IPE (R-3)

  • WIOA Programs/Credential Attainment/Measurable Skills Gains (R-4)

Comprehensive Annual Review

• Copy of IPE showing new review date and any changes made to the plan

• Information about any credentials earned with supporting documentation

• Information about any measurable skills gains earned with supporting documentation

Employment

• IPE showing employed status

  • SOC Code

  • Hours Worked and Wages

  • Start Date of Employment

Closure

• IPE showing closure information

  • Employment Information including Hours Worked and Wages

  • Monthly Public Supports

  • Medical Insurance Coverage

*Linda will provide any post-exit wage information she receives quarterly.