Workforce Development

Personal Characteristics

• SSN: 555-55-5554
• Disability: No
• Disability Type:
• Selective Service Registered: Yes
• Veterans Status: Yes, Other Eligible Person
• Campaign Veteran: Yes
• Disabled Veteran: No
• Recently Separated Veteran: Yes
• Employment at Registration: Not Employed
• Wages per hour Prior Six Months:
  $
• Migrant/Seasonal Status: Migrant Farmworker
• Unemployment Compensation Programs: N/A
• Citizen: Yes

Economic Information

• Income(annual):
  $
• Family Size: 5
• TANF: Yes
• General Assistance(GA), Refugee Assistance(RCA), or Supplemental Security Income(SSI): No
• Food Assistance: No
• Pell Grant: No
• Disaster Relief Assistance: No
• Low Income: Yes

Dislocated Worker Section

• Date of Dislocation: 5/20/2016
Dislocation Type
1. a). Has Notice or is Terminated or Laid-off from employment, AND
1. b). Unlikely to Return to Prior Industry or Occupation, AND
1. c). Eligible for or Exhausted Unemployment compensation OR
1. d). Meets One-Stop Center Attachment to Workforce
2) Has Notice or is Terminated or Laid-off from employment due to Plant, Facility, or Enterprise Closure
3) Employed at Facility Announced to Close within 180 Days
4) Self-employed but Unemployed because of General Economic Conditions or Natural Disaster
5) A displaced Homemaker
6) Employed at Facility Announced to Close, No Date

Barriers to Employment

• Limited English Language Proficiency: No
• Single Parent: No
• Foster Child: Yes
• Homeless: Yes
• Runaway Youth: Yes
• Offender: Yes
• Pregnant or Parenting Youth: Yes
• Youth-Needs Special Assistance: Yes
• Behind a Grade Level: Yes
• Other Barrier: Yes
If YES, Explain: