OhioMeansJobs Warren County WIOA Adult Funding Interest Form
WIOA training is specifically designed for individuals participating in the Workforce Innovation and Opportunity Act (WIOA) who are looking to further their education or upgrade their skills. Through tuition-paid training supported by OhioMeansJobs Warren County, students can acquire the necessary skills to enhance their employability and succeed in today’s highly competitive job market. Please note that filling out this interest form DOES NOT count as applying for funding. To apply for funding, you must first attend an in-person orientation session. Additionally, applying for funding does not guarantee that you will receive financial assistance. Please complete the following questions to register for our next orientation session. Effective 10/10/2024: The WIOA Adult program is currently closed. Any interest forms completed will be added to our waitlist, and you will be contacted via email once additional funding is made available. However, the WIOA Dislocated Worker program remains open for applications.
Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County of Residence
Please Select
Butler
Clermont
Warren
Other
How did you hear about us?
*
Facebook
Instagram
LinkedIn
Web Search
School Referral
Word of Mouth
Unemployment
Other
Date of Birth
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-
Month
-
Day
Year
Date
Marital Status
*
Single
Married
Separated
Family Size
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1
2
3
4
5
6
7
8 or more
High school graduate or GED obtained?
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Yes
No
Name of School & Graduation Year:
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List all vocational school certifications, apprenticeships/journeyman ratings, professional certifications, state licenses, professional licenses, and degrees that you have earned. Please include the year and the organization from which you received. Respond N/A if there are none.
*
Have you or anyone in your household received the following in the past six months?
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Cash Assistance
SNAP
No
Are you currently employed?
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Yes, full time
Yes, part time
No
Name of current employer, if applicable:
Hours worked per week:
Pay rate:
What is your family gross income for the past 12 months?
*
If unemployed, what is your current unemployment status:
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I have not filed unemployment
Claim filed
Receiving benefits
Exhausted benefits
N/A
Are you a military veteran or spouse of a veteran?
Yes
No
Prefer not to answer
List any criminal convictions & years. Respond N/A if there are none:
*
List any driving convictions & years. Respond N/A if there are none:
*
What training program are you interested in?
*
Please Select
Business credential
CDL
Dental Assistant
EMT
Fire Science
HVAC
Information Technology
LPN
Medical Assistant
Paramedic
Phlebotomy
RN
Something else
STNA
Welding
What school are you considering?
*
Please Select
Breakthrough Performance Group
Butler Tech
Cincinnati State
Dental Assistant Pro
Elite Welding
Great Oaks
Hobart Welding
Napier
Other/Unknown
QS Academy
Sinclair College
Southern State
Warren County Career Center
Comments:
I acknowledge that this form is for expressing interest and does not guarantee funding. I confirm that the information provided is accurate to the best of my knowledge.
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Continue
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