Forms

Contact Us
(530) 892-9600

Business Hours:
M-F: 8am - 5pm

Applicant Statement
Adult/Dislocated Worker
(Updated 3/25/2019)

Applicant Statement
Youth
(Updated 5/28/2020)

Complaint/Grievance Summary
Click here for the Spanish Version
(Updated 9/25/2018)

Documents for Life
(Word Document)

Eligibility Summary Checklist
Dislocated Worker
(Updated 9/23/2021)

Eligibility Summary Checklist
NDWG

Eligibility Summary Checklist
Youth
(Effective 1/1/2020; Last Updated 5/28/2020)

Eligibility Worksheet for Self-Sufficiency Standard

Equal Opportunity is the Law Statement
Click here for the Spanish Version
(Updated 3/5/2019)

OJT Employer
Documentation of New or Repeat OJT Employer
(Updated 6/15/2023)

P2E 2.0 Initial Interview Form
(Updated 6/1/2023)

P2E Eligibility Summary

Priority of Service – Adult Program

Quarterly Follow-Up Survey

RERP Eligibility Summary

RERP Initial Interview

Selective Service Affidavit
(Updated 3/25/2019)

Self-Attestation of Family Income and Size

Telephone Verification Form
(Updated 3/25/2019)

Unlikely to Return Form
Dislocated Worker
(Updated 12/6/2019)

WIOA Application
All Programs
Click here for the Spanish Version
(Updated 12/19/2022)