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Online WIOA Training Provider Application

This Application is a:

Provider Information

The training facility meets the requirements of the Americans with Disabilities Act (ADA)?
Please email the following items to Labor.ETP@vermont.gov
  • Program catalog/brochure
  • Current class schedule
  • Policies [specifically, tuition refund, EEO and Accessibility policies]
Type of Training: (check all that apply)
Type of Credential Issued: (check all that apply)
Footnote 1. For an initial eligibility determination, the Training Provider should provide any accurate information related to the requested performance measures and certify to the VDOL the ability to meet minimum performance levels and accurately submit the required information at the end of the performance period. Contact the VDOL, Workforce Development Division for further information (802-828-4151).
If the program is intended to prepare the student for licensure or certification, list the type of license and the name of the licensing or certifying entity

Total Hours of Instruction

Delivery Method: (check all that apply)

Class Size and Location

Program Approvals

Are students in the program eligible for Pell Grants under Title IV of the Higher Education Act of 1965?
Is this program approved by the Vermont State Board of Education?
Is the program approved by the U.S. Department of Education or other State Board of Education?

Program Description

Cost Information (per semester, per student)

$
$
Eligible Training Provider Performance Information
(Complete One Performance Information Sheet for Each Program)
Twelve‐month period of performance for training program being reported:
For an initial eligibility determination, the Training Provider should provide any accurate information related to the requested performance measures and certify to the VDOL the ability to meet minimum performance levels and accurately submit the required information at the end of the performance period. Contact the VDOL, Workforce Development Division for further information (802-828-4151).

Number of Program Participants

The percentage of program participants who are in unsubsidized employment during the second quarter after exit from the program
%
%

The percentage of program participants who are in unsubsidized employment during the fourth quarter after exit from the program

%
%

The percentage of participants who obtain:

%
%

Where appropriate, rate of successful completion by all participants of:

%
%
%

Note: The Eligible Training Provider will likely need to work with the VDOL in order to complete #3-5, above.

Authorized Signature

Certified by:
If this box is checked, this submission shall be considered as an authorized written signature.*
  • This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.