Class Reimbursement Request

Class Reimbursement Request

FILLING OUT THIS APPLICATION DOES NOT REGISTER YOU FOR CLASS AND DOES NOT GUARANTEE THAT YOU WILL RECEIVE TRAINING OR COST REIMBURSEMENT.
Eligibility Requirements

To ensure your application is processed correctly, it's important to first register for the class at www.alaskacharr.com.

To be eligible for reimbursement, you must:
- Be an Alaska Resident. Proof of Alaska residency is through an Alaska Driver's License or State ID.
- Have worked in a position covered by Unemployment Insurance (UI) in Alaska or another state within the past five years.
- If unemployed, have applied for, or be receiving, UI benefits, or have exausted the right to UI benefits within the past three years.
- Have submitted this application BEFORE completing your training.
Any applications received AFTER training has already been completed will not be eligible.

If you encounter any issues or have questions, please reach out to the STEP Grant Program Coordinator, Kat Duren, at 907-217-8138 or STEP@alaskacharr.com

Compliance with these steps is crucial for the approval of your application.
Getting your reimbursement:

Your application will be reviewed once you have registered, paid, and completed a TAP or ServSafe class. Reimbursements will be processed the following month (For example, October reimbursement requests will be processed in November, etc.). Reimbursements will be issued to the ORIGINAL FORM OF PAYMENT.
The Alaska CHARR Educational Fund receives STEP (State Training and Employment Program) grant funding, which funds approximately 60% ($200,000) of the program. Thank you to the State of Alaska, Workforce Investment Board, for supporting the Alaska hospitality industry.
Participant Information
Legal Name*

First NameMiddle NameLast Name
Address*

Street Address

Mailing Address (PO Box, HC, etc)

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Phone Type*

VoiceTTYVoice/TTYVideophoneAmplified Phone
Are you an Alaska Resident that has resided in the state for the past 30 days and intend to make Alaska your home?*

YesNo
Have you worked in a position that contributed to Unemployment Insurance (U.I.) in Alaska or another state with similar provisions sometime in the last five years? (Have you had a job within the last 5 years?)*

YesNo
Are you currently employed?*

YesNo
If unemployed, have you applied for, or are you receiving UI benefits, or have your exhausted the right to UI benefits within the past three years?*

YesNo
Are you in a Registered Apprenticeship?*

YesNo
Which class will you attend?*

ServSafe ManagerTraining for Alcohol Professionals (TAP)
What date will you attend class? The class date cannot be before the application date. *

MonthDayYear
Date
AlaskaJobs Required Questions

FILLING OUT THIS APPLICATION MEANS: This information will be used to register you on the Alaska Jobs Website if you're not already registered. Registration through this process will in no way impact any benefits you receive from the state or county. Completing this information will grant the State of Alaska and all its administrative subdivisions the irrevocable right to use my likeness, comments, or personal story or all in media presentations, any of which may be reproduced and publicly distributed in media such as in photographs, videos, advertisements, and newspaper and magazine articles for public information, marketing, or policy discussions. This release is unconditional. I waive any right that I may have to inspect and approve the image or commentary that may be used. I release the State of Alaska and its administrative subdivisions from any claim(s) for compensation associated with the use of these images and/or commentaries.
Do you have a MyAlaska Account? (AlaskaJobs website username)*

YesNo
What is your MyAlaska Username (To Access AlaskaJobs only)
Upload your resume for AlaskaJobs and your Alaska CHARR profile. This is optional and will not be shared with any additional entities outside Alaska CHARR, its entities, and/or the AlaskaJobs Web Portal.

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Social Security Number:*
Date of Birth:*

MonthDayYear
Date
Gender Identity:*

FemaleMaleNon-BinaryI do not wish to answer
Which of the following best describes your US Citizenship:*

U.S CitizenU.S Permanent Resident AlienRefugee / ParoleeTemporary Work PermitNone of TheseOther
Who is your current employer?*
What is your desired Job Title?*
Which of the following best describes why you are seeking training?*

In need of training to improve the prospect of obtaining or retaining employment (Keep your current job OR because you've been hired for a new job)Unemployed and receiving Unemployment Insurance (UI) benefitsUnemployed but not receiving Unemployment Insurance (UI) benefitsEmployed but likely to be displaced because of the reduction in overall employment within the business (Employees are being laid off)Employed but likely to be displaced because of the elimination of your current job (Your job position is no longer needed)Employed but likely to be displaced because of a change requiring that to remain employed, they must learn substantially different skills (Your job requires more advanced skills that you must to training for)
Do you need this training to remain a self-sufficient wage earner?*

YesNo
Do you prefer to receive your notifications from the State of Alaska via Text or Email?*

TextEmail
Please provide your race / ethnicity (check all that apply):*

White / CaucasianBlack / African AmericanAmerican Indian / Alaska NativeAsianHawaiian / Pacific IslanderI do not wish to answerOther
Are you of Hispanic or Latino heritage?*

YesNoDo not wish to answer
If you experience a disability, are you able to perform the essential functions of this job or training program with or without reasonable accommodation?*

I do not have a disabilityYes, I can perform the essential functionsNo, I cannot perform the essential functions
Are you currently homeless?*

YesNo
Military Affiliation
Are you currently in the U.S Military or a Veteran?*

YesNo
Please provide the last active duty date:*

MonthDayYear
Date
Are you a member of the Armed Forces who is wounded, ill or injured and receiving treatment in a military facility or warrior transition unit?

YesNo
Have you attended a Transition Assistance Program (TAP) Workshop within the last 3 years?

YesNo
Are you within 24 months of retirement or 12 months of discharge from the military (Transitioning Service Member)?

YesNo
Have you served and were discharged from active duty as a member of the National Guard or Reserve Unit during an armed conflict and or crisis involving national security (Title 10 Activation) for which a campaign is authorized?

YesNo
Most Recent Active Duty begin date (mm/dd/yyyy):
Most recent Active Duty end date (mm/dd/yyyy):
Branch of Service:
Most recent Character of Service received:
Do you have prior service dates?
Received a Military Campaign Badge

YesNo
Disabled Veteran?

YesNo
If you answered yes to the above question, what is your disability percentage?
Received services from Veteran's Voc Rehab (Chapter 31)?

YesNo
Are you currently incarcerated or have you been released from incarceration?

YesNoIn do not wish to disclose
Within the last 12 months, have you been unemployed for 27 or more weeks?

YesNoNot Sure
Veteran Status:
Recently seperated (within 3 years)?
Are you the spouse of a member of the armed forces who is on active duty?*

YesNo
Are you the spouse of a veteran who has a permanent, total service-connected disability or had the disability at the time of death, or died while the disability was in existence? -OR- A spouse of a service member on active duty who died or has been Missing In Action (MIA), captured in the line of duty or forcibly detained for a total of more than 90 days?*

YesNo
Education Information
What is the highest level of education you have received?*

No school grades completedSome High School completedHigh School Equivalency DiplomaHigh School DiplomaSome CollegeCollege Graduate
Are you attending school?*

Yes, Middle SchoolYes, High SchoolYes, College or Technical / Vocational SchoolNo
Applicant Certification and Release of Information
My signature below affirms the certifications, media release, and release of information listed below:

✓ I certify to the best of my knowledge that the information in this application is accurate, true, verifiable, and subject to verification.
✓ I understand that the answers I have provided in this application are considered self-attestation, and I may be asked to provide proof to support my answers.
✓ I understand that falsification of information to receive grant benefits may be grounds for removal from the program, and/or I may have to repay benefits received.
✓ I certify that I am an Alaska resident, and I intend to stay in Alaska and make it my home.
✓ I certify that I have reviewed a copy of the Program Complaints and Appeals Policy, which describes the complaint and appeals process with regard to program complaints and discrimination complaints. (attached below)
✓ I certify that I have reviewed a copy of the Program and Equal Opportunity Discrimination Complaint Information document and have read and understand the contents of this document. (attached below)
✓ I agree to the use of the personally identifiable data collected on this form, including my Social Security number, for use by the Alaska Department of Labor to measure the performance and outcomes of the activities conducted under the AWIB.
✓ I understand that the funds I am applying to receive are for training or support services from the STEP program, which is funded from a percentage of employee payroll tax contributions to Unemployment Insurance. I agree to complete a survey or other inquiry regarding the training or services received from the STEP program and my employment outcome after receiving the services or training.
Program Complaints and Appeals Policy:
Program and Equal Opportunity Discrimination Complaint Information:
I grant the State of Alaska and all its administrative subdivisions the irrevocable right to use my likeness, comments, or personal story or all in media presentations, any of which may be reproduced and publicly distributed in media such as in photographs, videos, advertisements, and newspaper and magazine articles for public information, marketing, or policy discussions. This release is unconditional. I waive any right that I may have to inspect and approve the image or commentary that may be used. I release the State of Alaska and its administrative subdivisions from any claim(s) for compensation associated with the use of these images and/or commentaries.*

I DOI DO NOT
Please upload a copy of your Alaska state ID: *

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Applicant Signature:*

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Parent or Guardian Signature (If the applicant is under the age of 18)

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Should be Empty:

Class Reimbursement Request

Getting your reimbursement:

Participant Information

AlaskaJobs Required Questions

Military Affiliation

Education Information

Applicant Certification and Release of Information