Indiana Career Connect Staff Training System Registration Templates

Size: px

Start display at page:

Download "Indiana Career Connect Staff Training System Registration Templates"

Blaise Fields
5 years ago
Views:

1 Indiana Career Connect Staff Training System Registration Templates Please use the following information to create practice profiles for training. Individual System Registration (WP & WIOA Adult/DW) Login Social Security SSN XX, where XX is trainer-assigned Primary Location Authorized to Work in U.S.? of Birth Any month/any date/1995 or earlier Selective Service Registration if Male; System-set if Female Name First/Last Name Residential and Address Line 1 Phone s Primary Phone/Phone Type tification Site Access Accessing website from? Disability Do you have a disability? Highest Level Achieved? High School Diploma (or more advanced) Are you attending school? Current Status t Working Type of Business Worked in Private Business, neither claimant nor exhaustee Termination or Separation? Farm Worker Last 12 months ICC Staff Training System Registration Templates V1.0 Page 1

2 Ethnic Origin Hispanic or Latino Heritage? Chef Chefs and Head Cooks Language Primary spoken language Military Service (if, data entry required) # Individuals in Household 4 Income for last 6 months $ Maintain defaults Employer System Registration Employer Identification Login Employer Identification Primary Location Info FEIN Company Name Street Address XX, where XX is trainer-assigned (restaurant/eatery) Contact Company Info Job Title First/Last Name Primary Phone tification Company Website Owner or Manager (not required) Industry Title (NAICS) Full-Service Restaurant (722110) of Employees Type of Employer Federal Contractor? Staffing Firm? Private Sector Company Profile Company Profile Make one up Benefits Offered Company Benefits ICC Staff Training System Registration Templates V1.0 Page 2

3 Individual System Registration (WIOA Out-of-School Youth) Login Social Security Primary Location SSN Authorized to Work in U.S.? of Birth Selective Service Registration XX, where XX is trainer-assigned 02/02/2000 (16 yrs old!) Female N/A (system-set) Name First/Last Name Residential and Address Line 1 Phone s Primary Phone/Phone Type tification Site Access Accessing website from? Disability Do you have a disability? Highest Level Achieved? 10 th Grade (High School Dropout) Are you attending school? Current Status Never Worked Type of Business Worked in N/A NO, neither claimant nor exhaustee Termination or Separation? N/A Farm Worker Last 12 months N/A N/A Ethnic Origin Hispanic or Latino Heritage? ICC Staff Training System Registration Templates V1.0 Page 3

4 Language Primary spoken language Military Service (if, data entry required) Food Stamps # Individuals in Household N/A Income for last 6 months N/A Individual System Registration (TAA) Login Social Security Primary Location SSN Authorized to Work in U.S.? of Birth Selective Service Registration Name First/Last Name Residential and Address Line XX, where XX is trainer-assigned Any month/any date/ if Male; System-set if Female Phone s Primary Phone/Phone Type tification Site Access Accessing website from? Disability Do you have a disability? Highest Level Achieved? Are you attending school? Current Status Type of Business Worked in High School Diploma t Working Private Business, claimant, not profiled and referred ICC Staff Training System Registration Templates V1.0 Page 4

5 Termination or Separation? Farm Worker Last 12 months Ethnic Origin Hispanic or Latino Heritage? Chef Chefs and Head Cooks Language Primary spoken language Military Service (if, data entry required) Maintain defaults # Individuals in Household 4 Income for last 6 months $2, Remember Your Login! Account Login / First Name / Last Name Individual Login (WP & WIOA) Employer Login (WP) Individual Login (WIOA Youth) Individual Login (TAA) Staff Login iccstaff Training@1 ICC Staff Training System Registration Templates V1.0 Page 5

College of Lake County Children s Learning Center Child Care Access Means Parents in School CCAMPIS Grant Application (Please print or type)

CCAMPIS# Date Received College of Lake County Children s Learning Center Child Care Access Means Parents in School CCAMPIS Grant Application (Please print or type) Approved Denied: Date: 1. Student-parent