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Forms Page

Workforce Investment Act (WIA) and Alameda County Workforce Investment Board (ACWIB) Forms

Form Name Form Description Form File
ACWIB General Forms
Client Grievance Complaint Filing Form Spanish Client Grievance Complaint Filing Form Spanish WIBClient Grievance-Complaints Filing Form 20081-spa.doc
Client Grievance Complaint Filing Form Vietnamese Client Grievance Complaint Filing Form Vietnamese Client Grievance-Complaints Filing Form 2008_Vietnamese.doc
Clients Rights Summary Form Chinese Clients Rights Summary Form Chinese CHINESE-Client Rights Summary Form Revised 2008.doc
Clients Rights Summary Form Spanish Clients Rights Summary Form Spanish WIBClient Rights Summary Form Revised 2008-spa.doc
Clients Rights Summary Forms Translated Into Spanish, Chinese and Vietnamese Client Grievance Filing Form Chinese CHINESE-Client Grievance-Complaints Filing Form 2008.doc
Clients Rights Summary Vietnamese Summary Vietnamese Client Rights Summary Form Revised 2008_Vietnamese.doc
Grievance and Complaint Procedures Grievance and Complaint Procedures 2008 AB 8 2008 Grievances Complaints Bulletin.pdf
NOTIFICATION OF COMPLAINT/GRIEVANCE NOTIFICATION OF COMPLAINT/GRIEVANCE Client Grievance-Complaints Filing Form 2008.pdf
Particip[anClient Reimbursement Form Revised 12/3/2010 Client Reimbursement Form Revised 12/3/2010 Part Reimburse WIA 11-20-10.doc
Respondent Form Complaints Chinese Respondent Form Complaints Chinese CHINESE-Respondent Form Complaints 2008.doc
Respondent Form Complaints Vietnamese Respondent Form Complaints Vietnamese Respondent Form Complaints 2008_Vietnamese.doc
WIB Conflict of Interest Policy Alameda County Workforce Investment Board (ACWIB)Conflict of Interest Policy Conflict of Interest Policy - FINAL.pdf
Respondent Form Complaints Spanish Respondent Form Complaints Spanish WIBRespondent Form Complaints 20081-spa.doc
SUMMARY NOTIFICATION OF RIGHTS AND COMPLAINT PROCEDURES SUMMARY NOTIFICATION OF RIGHTS AND COMPLAINT PROCEDURES Client Rights Summary Form Revised 2008.pdf
ACWIB COMPLAINT PROCEDURES ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
COMPLAINT PROCEDURES
Grievance-Complaint Procedures 2008.pdf
Incident Report for Fraud, Criminal Activity, Mismanagement or Waste Incident Report for Fraud, Criminal Activity, Mismanagement or Waste Incident report form 2008.pdf
NOTIFICATION OF COMPLAINT NOTIFICATION OF COMPLAINT
RESPONDENT INFORMATION
Respondent Form Complaints 2008.pdf
Batch Log 2009 Batch Log 2009 7 batch log revised Oct 2009.xls
 
Customized/Upgrade Training
Customized Training Master Agreement Customized Training Master Agreement Revised 4/30/2010 CT Master Agreement Template 4-30-10.pdf
Customized/Incumbent Worker Referral Form Customized/Incumbent Worker Referral Form revised 8/24/2010 #27 CT Referral Form Final 8-24-2010.doc
Customized/Upgrade Training Application Customized/Incumbent Worker Training Application ACWIB Customized Training Application 06 21 11.dot
Customized/Upgrade Training Monitor Report Customized/Upgrade Training Monitor Report CT Monitoring Report 9-18-06.doc
Customized/Upgrade Training Referral Form Customized/Upgrade Training Referral Form Revised 8-24-2010 (pdf) #27 CT Referral Form Final 8-24-2010.pdf
Employer Worksheet - Union Concurrence Employer Worksheet - Union Concurrence Form Employerinformationwrksht 8-28-10.doc
 
Eligible Training Provider List (ETPL)
Eligible Training Provider List (ETPL) Application Eligible Training Provider List (ETPL) Application revised 2/02/2011 EASTBAY_Works_ETPL_APPLICATION 2011.doc
ETPL Application Checklist ETPL Application Document Checklist ETPL CHECKLIST 9-09-08.pdf
ETPL Application Instructions ETPL Application Instructions ETPL InstructionsA 2009.pdf
 
Individual Training Account (ITA) Training Forms
Classroom Training (ITA) Request Form Classroom Training (ITA) Request Form Classroom Training Request - Rev 6-14-051.doc
Client Reimbursement Form Revised 12/3/2010 Client Reimbursement Form Revised 12/3/2010 Part Reimburse WIA 11-20-102.doc
ITA Cancellation/Refund Form ITA Cancellation/Refund Career Counselor Worksheet CAREER COUNSELOR WORKSHEET 06 06 06.doc
ITA Career Counselor Worksheet ITA Career Counselor Worksheet career counselor ITA worksheet 06 06 06.dot
ITA Modification Form 12-2010 ITA Modification Form 12-2010 ITA Modworksheet rev 12-2010.doc
ITA Monitoring Form ITA Monitoring Form ITA Monitoring Site Visit-customer.doc
ITA Occupational Training Supplies Authorization Occupational Training Supplies Authorization (ITA) Occupational Training Supply Authorization 06 06 06.doc
ITA Pre-Contract Site Visit Compliance Monitoring Report ITA Pre-Contract Site Visit Compliance Monitoring Report ITA Pre-Contract Site Visit Compliance Monitoring Tool - Monitor.doc
 
One-Stop Forms
AB 65 Direct Referral Form Postponement of Steps to Success AB 65 Direct Referral Form Postponement of Steps to Success AB 65 - RevisedPostponementofStepsRefForm0107(Attach).doc
AB 65 Steps to Success  Employer Initiated Referral Form AB 65 Steps to Success  Employer Initiated Referral Form AB 65 - StepsToSuccessEmployerInitiated(Attach).doc
Adult/Dislocated Worker Document Checklist WIA Adult and Dislocated Worker Documentation Checksheet. Adult-DW Document Checklists1 11-08-06.xls
Adult/Dislocated Worker Exit Form Adult/Dislocated Worker Exit Form 5 EWIT adult diswk exit 10 24 061.xls
Adult/Dislocated Worker Follow-Up Form Adult/Dislocated Worker Follow-Up Form 6 EWIF follow up 11 0511.xls
Adult/Dislocated Worker Non-Training Enrollment Form WIA Adult/Dislocated Worker Non-Training Enrollment Form ADW 2 EWIE non training enrollment 09 051.xls
Adult/Dislocated Worker Training Enrollment Form WIA Adult/Dislocated Worker Training Enrollment Form 3 EWIE training enrollment 09 0511.xls
Client Reimbursement Form Revised 12/3/2010 Client Reimbursement Form Revised 12/3/2010 Part Reimburse WIA 11-20-101.doc
EASTBAY Works ONE-STOP BUSINESS AND CAREER CENTER GENERAL POLICIES AND PROCEDURES (RULES) EASTBAY Works ONE-STOP BUSINESS AND CAREER CENTER GENERAL POLICIES AND PROCEDURES (RULES. batch log revised Oct 2009.xls
ESR Quarterly Report Template Employer Services Quarterly Report Template EMPLOYER SERVICES Quarterly Report Template 2-28-07.doc
IB #22 Updated Exit Form IB #22 Updated Exit Form IB - 22 Exit Form(Attach)1.xls
Intensive Service to Training Service Determination Form Intensive Service to Training Service
Determination Form
IntensiveTrainingDeterminationForm.doc
ITA-OJT Counselors Handbook 2007 ITA-OJT Counselors Handbook 2007 hanbook.zip
Monitoring Guide for One-Stop Career Centers WIA PROGRAM MONITORING GUIDE FOR ONE-STOP CAREER CENTERS

Program Monitor Guide One-Stops 2006-2007, Rev 2.doc
Referral to Additional Services Referral to Additional Services Letter of Introduction ACCESS Referral Form 11-06.doc
Staff-Assisted to Intensive Services Form Staff-Assisted to Intensive Services
Determination Form
StaffAssistIntensiveDeterminationForm 07-05.doc
Steps to Success Form Steps to Success Form (Rev 11/3/06) StepsToSuccessDirectReferral10-06 rev.doc
Talent Scout Referral Form Talent Scout Referral Form Talent Scout Referral.doc
WIA PARTICIPANT REIMBURSEMENT CLAIM WIA PARTICIPANT REIMBURSEMENT CLAIM Revised 3/04/2011 Part Reimburse WIA 3-02-11.doc
 
On-the-Job Training (OJT) Forms
Client Reimbursement Form Revised 12/3/2010 Client Reimbursement Form Revised 12/3/2010 Part Reimburse WIA 11-20-103.doc
OJT Account Procedure 05-10-2011 On-the-Job (OJT) Account Procedure revised 05/10/2011 OJT Account Procedures rev 5-10-11.pdf
OJT Employer Info Worksheet and Union Concurrence 5-10-2011 On-the-Job Training (OJT) Employer Information Worksheet and Union Concurrence Attachment A revised 5/10/2011 OJT Employer Info Worksheet & Att A - Rev 5-18-11.doc
OJT Invoice Form 5-10-2011 OJT Invoice Form revised 5-10-2011 Invoice OJT 5-10-11.doc
OJT Master Agreement Revised 5-10-2011 OJT Master Agreement Revised 5-10-2011 (Word File) OJT Master Agreement rev 5-10-11.doc
OJT Modification Worksheet 5-10-2011 On-the-Job Training (OJT) Modification Worksheet revised 5/10/2011 OJT Mod Worksheet 5-18-11.doc
OJT Monitoring Report 5-10-2011 On-the-Job Training (OJT) Monitoring Report revised 5/10/2011 Monitor form 5-10-2011.doc
OJT Referral Form 5-10-2010 On-the-Job Training (OJT) Referral Form revised 5/10/2011 OJT Referral Form 5-10-11.doc
OJT Tool/Equipment Authorization OJT Tool/Equipment Authorization OJT Tool Authorization Form.doc
 
Rapid Response
Petition for TAA and ATAA Petition for Trade Adjustment Assistance (TAA) and
Alternative Trade Adjustment Assistance (ATAA) 2-15-2011

Online application:
https://www.etareports.doleta.gov/petition/index.cfm?reset=true
TAA Petition 2-15-2011.pdf
Petition for TAA/ATAA (Spanish) Solicitud de Asistencia para Ajuste del Comercio (TAA) y
Asistencia Alternativa para Ajuste del Comercio (ATAA) 2-15-2011
TAA Petition Spanish 2-15-2011.pdf
Rapid Response Policy and Procedure PY 2011 Rapid Response Policy and Procedure PY 2011/12 RAPID RESPONSE POLICIES-PROCEDURES 2011-12.doc
 
Request for Proposals (RFP)
CTS Bidders Conference Q & As July 1,2009 RECOVERY ACT  CAREER TRANSITION SERVICES RFP BIDDERS CONFERENCE
QUESTIONS & ANSWERS
July 1, 2009
CTS Bidders Q&A 7-01-09.pdf
CTS Follow-Up Question July 20, 2009 Additional question received via email on Monday July 20, 2009. CTS RFP Question.pdf
REQUEST FOR PROPOSALS - CAREER TRANSITION SERVICES REQUEST FOR PROPOSALS - CAREER TRANSITION SERVICES for Dislocated Workers. (PDF)
CTS Application REVISED 6-18-09.pdf
REQUEST FOR PROPOSALS - CAREER TRANSITION SERVICES REQUEST FOR PROPOSALS - CAREER TRANSITION SERVICES for Dislocated Workers. (Word) CTS Application REVISED 6-18-09.doc
REQUEST FOR PROPOSALS (RFP) FOR ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD STRESS COUNSELING SERVICES REQUEST FOR PROPOSALS (RFP) FOR
ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
STRESS COUNSELING SERVICES
StressCounselingRFPAnnouncement 6.091
REQUEST FOR PROPOSALS (RFP) FOR EMPLOYMENT PLUS II PROGRAMS FOR HIGH-RISK YOUTH ALL SERVICE AREAS REQUEST FOR PROPOSALS (RFP) FOR EMPLOYMENT PLUS II PROGRAMS FOR HIGH-RISK YOUTH ALL SERVICE AREAS RFP Youth Announcement-Mailout 10-26-10.doc
STRESS COUNSELING PROGRAM RFP BIDDERS CONFERENCE QUESTIONS & ANSWERS STRESS COUNSELING PROGRAM RFP BIDDERS CONFERENCE QUESTIONS & ANSWERS from June 16, 2009.
Stress Counseling Bidders' ConferenceQA.6.17.09
Stress Counseling Services Request for Proposals Stress Counseling Services Request for Proposals Stress Counseling RFP 6.10.09
Stress Counseling Services Request for Proposals Forms Stress Counseling Services Request for Proposals Forms Stress Counseling RFP Part II Forms 6.10.09
SYEP RFP Part I 2009-2010 Summer Youth Employment Program May 1 through September 30, 2009. Proposal Submission Deadline: Monday, April 6, 2009 3:00 pm RFP SYEP 2009 Part I - Final 3-16-091.pdf
SYEP RFP Part II 2009-2010 Summer Youth Employment Program May 1 through September 30, 2009. Proposal Submission Deadline: Monday, April 6, 2009 3:00 pm RFP SYEP 2009 Part II Forms Final 3-17-09.pdf
ANNOUNCEMENT - REQUEST FOR PROPOSALS (RFP) For ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD CAREER TRANSISTIONAL SERVICES REQUEST FOR PROPOSALS (RFP) For
ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
CAREER TRANSISTIONAL SERVICES
ANNOUNCEMENT CTS 6-11-09.pdf
EDEN AREA ONE-STOP CAREER CENTER RFP REQUEST FOR PROPOSALS (RFP) For
ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
EDEN AREA ONE-STOP CAREER CENTER
RFP Announcement for Eden Area One-Stop 10-07.doc
Posting Q&A from Youth RFP Bidders' Conference Posting Q&A from Youth RFP Bidders' Conference Questions & Answers from the Youth.
RFP Bidders Conference- Employment Plus Programs, Tuesday, October 9, 2007 are posted.
BIDDERsconf QA.10.09.07 Youth.doc
NORTH CITIES ONE-STOP CAREER CENTER RFP REQUEST FOR PROPOSALS (RFP) For
ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
NORTH CITIES ONE-STOP CAREER CENTER
RFP Announcement for North Cities One-Stop 10-07.doc
EMPLOYMENT PLUS PROGRAMS FOR HIGH-RISK YOUTH REQUEST FOR PROPOSALS (RFP) For
ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
EMPLOYMENT PLUS PROGRAMS FOR HIGH-RISK YOUTH 
ALL SERVICE AREAS
RFPYouth Announcement 2008-11.doc
 
STRATEGIC FIVE-YEAR PLAN/LOCAL PLAN MODIFICATION
Notice Of Public Comment Tenth-Year Modification Alameda County Local Workforce Investment Areas
Strategic Five-Year Local Plan Modification for PY 09-10


Per the States Directive WIA WSD09-7, the Alameda County Workforce Investment Board (ACWIB) is submitting a draft copy of its Local Plan Modification for Program Year 09-10. The Draft Plan now requires full ACWIB approval, which is scheduled to occur on May 13, 2010. It will be approved by the ACWIB and subsequently signed by the Chairman of this meeting.

The Alameda County Board of Supervisors will approve the Final Plan at their May 25, 2010 meeting. Shortly thereafter, six copies of the completely executed Plan along with the required signatures and attachments will be sent to the State.

For any questions, please contact me at (510) 259-3844.

Sincerely,




Dorothy Chen
Director

2009 Local Plan ARRA Narrative Plan DRAFT.docx
10th Year Mod 10th year modification (cont) 5-yr Plan Mod 10th yr 09-10 DRAFT 3-31-10.doc
10th Year Mod Budget Summary 10th Year Mod Budget Summary WIB 09-10 fwsdd-29 Budget Summary 2-22-10.xls
10th Year Mod Paricipant Plan 10th Year Mod Paricipant Plan ParticipantPlanSummary.xls
10th Year Plan Mod MOUs 10th Year Plan Mod MOUs MOU Attachment.doc
10th Year Mod ARRA Participant Plan 10th year mod (cont)ARRA Participant Plan ARRAParticipantPlanSummary.xls
Budget Plan 2007/2008 Budget Plan 2007/2008 Budget Plans FY07-08.xls
STRATEGIC FIVE-YEAR PLAN/LOCAL PLAN MODIFICATION STRATEGIC FIVE-YEAR PLAN/LOCAL EIGHT YEAR PLAN MODIFICATION open for comment. WIA- PY07-08 Plan Modifications.doc
WIA Plan Addendum X WIA PLan Addendum X WIA Plan Addendum X.rtf
Budget Plan 2008/2009 Budget Plan for PY 2008/2009 Attachment B - Budget Summaries.xls
Notice Of Public Comment Ninth-Year Modification We are submitting the draft Ninth-Year Modification to the Alameda County Local Workforce Investment Area for your review and comment.

Each year, the Local Workforce Investment Boards are required to submit modifications to the original plan that may include: the submission of required elements missing from previous plans; reports on significant changes in local economic conditions; changes in leadership structure; and changes in program strategies to address performance goals and community needs.

All previous Plan Modifications have been incorporated into the body of the original Strategic Ninth-Year Plan. The full plan is available to view upon request as a MS Word document email attachment, and as a hardcopy at our office. You may also go to our website at www.acwib.org. to retrieve a copy.

Please send your comments, referencing the section and page number of the original plan, in writing to be received by our office no later than the close of business on November 18, 2008 to:

Ninth-Year Modification Plan Comments
Alameda County Workforce Investment Board
Attn: Dorothy Chen
24100 Amador St., 6th Floor
Hayward, CA 94544-1203

You may also email your comments with the subject title Ninth-Year Modification Plan Comments to: dchen@acgov.org We look forward to your invaluable feedback.

To request a full copy of the plan, please contact Flo Fox at 510-259-3842 or via email ffox@acgov.org and a copy of the plan will be emailed to you.
5-yr Plan Modifications 9th yr 08-09 FINAL.pdf
Participant Plan Summary Participant Plan Summary ParticipantPlanSummary0708.xls
Participant Plan Summary 2008/2009 Participant Plan Summary Attachment D - Participant Plan Summary.xls
 
Survey Forms
Job Fair/Recruitment Survey Job Fair/Recruitment Survey JOB FAIR SURVEY EBW logo.doc
 
WIB PowerPoint Presentations
OJT and Other Mysteries of the Universe This PowerPoint presentations attempts to exlain the process, policies and procedures of an OJT contract. Revised 3-03-2011 OJT Mysteries 12-2006 Rev 3-03-11.ppt
One Stop Employer and WIB Business Services Defined This brief PowerPoint presentation defines the roles of Employer Services at the One Stop Career Center level and Business Services at the WIB level. BUSINESS Services Slide Show 9-8-08.ppt
 
Youth Program Forms
Batch Log Batch Log 7 batch log revised 03 21 061.xls
Monitoring Guide for Youth Program Operators WIA PROGRAM MONITORING GUIDE FOR YOUTH PROGRAM OPERATORS Program Year 2007-2008
Program Monitor Guide Youth 2006-2007-3.doc
Questions & Answers for EPP-II RFP Bidders Conference 10/7/10 ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
WIA YOUTH PROGRAMS  EMPLOYMENT PLUS-II PROGRAM
RFP BIDDERS CONFERENCE

THURSDAY, OCTOBER 7, 2010

QUESTIONS & ANSWERS
YouthRFPQA10 7 10 Final Version.doc
SYEP Bidder's Conference March 20, 2009 Questions and Answers ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD

RECOVERY ACT  SUMMER YOUTH EMPLOYMENT PROGRAM

RFP BIDDERS CONFERENCE

QUESTIONS & ANSWERS

March 20, 2009
ACWIB YOUTH RFP Q & A 3-26-09.pdf
SYEP PARTICIPANT TRANSPORTATION SUMMER YOUTH EMPLOYMENT PROGRAM

PARTICIPANT TRANSPORTATION
SYEP Participant Transportation.pdf
SYEP SUPPORT SERVICE POLICY AND PROCEDURES ALAMEDA COUNTY WORKFORCE INVESTMENT BOARD
SUMMER YOUTH EMPLOYMENT PROGRAM (SYEP)

SUPPORT SERVICE POLICY AND PROCEDURES
Effective June 1, 2009

Applicable to Provision of all Types of Support Services

SYEP AB 81 - Attachment - SYEP Support Service Policy.pdf
SYEP TRANSPORTATION REIMBURSEMENT CLAIM SUMMER YOUTH EMPLOYMENT PROGRAM

TRANSPORTATION REIMBURSEMENT CLAIM

SYEP Transportation Reimbursement Claim.pdf
Youth Document Checklist Youth In School/Out of School Checksheet for Eligibilty Youth Document Checklists 11-08-06.xls
Youth Enrollment Form Youth Enrollment Form Youth 2a EWIE youth enrollment 09 051.xls
Youth Exit Form WIA Youth Exit Form youth exit 5 EWIT 09 051.xls
Youth Follow-Up Information Form YWIA outh Follow-Up Information Form Youth 6 EWIF follow up 11 051.xls
Youth Goals Form WIA Youth Goals Form Yoth EWIG youth goals 09 051.xls
Youth Test Scores Form Youth Test ScoresForm (revised) youth test scores revised 4a 07-25-061.xls
 
     
 
  ACWIB
24100 Amador Street, 6th Floor
Hayward, CA 94544-1203
Click here for directions
Phone: (510) 259-3842
Fax: (510) 259-3845
Email: rbertuccelli@acgov.org
 
     
  The Alameda County Workforce Investment Board is a WIA Title I financially assisted
program or activity and is an equal opportunity employer/program. Auxiliary aids
and services are available upon request to individuals with disabilities.
 
     
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