Funded Training Application

Customer First Name:

Customer Last Name:

NYID:

Desired Training:

Desired Training Provider:

Start Date of Desired Training:

Current Education Level:

1. How does your desired training align with your career goals and aspirations?

2. Please explain how your prior educational and/or previous employment relates to your desired training.

3. If your desired training does not relate to your past experience, please explain your reason for seeking this training.

4. List or describe core job duties that are expected of the occupation(s) you would apply for post- training.

5. Describe any challenges/barriers that may negatively impact your participation in training.

State Your Name:

, agree to the following terms and conditions if I am accepted for funded training services through HempsteadWorks Career Center:

I understand that funding for training is not an entitlement and may be limited or unavailable.

I understand that I am only eligible for (1) training service regardless of whether I complete, pass, or fail the course, or if I pass or fail any required certification test(s) after I complete training.

If applicable, I agree to work with my Career Counselor to explore my desired training or other training options through Transfr-VR.

I agree to remain in contact with my Career Counselor during the training program and will provide employment placement and credential attainment information upon completion of the training program.

I hereby certify that, to the best of my knowledge, the information I have provided is true and accurate.

Customer Signature: (Please sign with your mouse).

Today's Date:

Thank you for your submission.

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