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WIOA Pre-Screening Application

The purpose of the Pre-Application Screening Form is for applicants to provide information that can be reviewed to determine their possible eligibility for WIOA program services. The completion and submission of the form by an applicant does not constitute a definitive eligibility determination but allows the CDC Central Eligibility Coordinator reviewing the form to decide if the applicant should be requested to report to your local American Job Center to complete a final eligibility determination and WIOA program enrollment.

Thank you for your interest in the Workforce Innovation and Opportunity Act (WIOA) Program.

To better serve you, please fill out the attached WIOA Pre-Application Screening Form and be prepared to email the following documents to [email protected]
• Birth Certificate
• Social Security Card
• Louisiana Driver's License or Picture I.D.
• Check stubs from all individuals in the household that have a job or W-2 holding forms,
   or income taxes.
• Proof of Address (utility bill, or letter received in the mail)

The following if applicable:
• Selective Service Letter (Males 18 or older)
• Verification of Food Stamp amount
• Social Security Award Letter (includes SSI)
• Unemployment Insurance information
• DD214 or Discharge papers if you are a Veteran

Prior to receiving any WIOA services the individual must undergo extensive testing evaluation and assessment processes to determine eligibility and suitability for services. You will also be administered a basic math and reading test. You may re-test after six months. With return of the attached pre-application form, you agree to attend all testing evaluations, and counseling sessions when scheduled; and to cooperate with the CDC Account Executive in establishing your needs, goals, and steps to be taken to achieve those goals

Pre-Screening Application

EQUAL OPPORTUNITY EMPLOYER/PROGRAM AUXILIARY AIDS AND SERVICES ARE AVAILABLE UPON REQUEST TO INDIVIDUALS WITH DISABILITIES

Deaf: Louisiana Relay Services TTY (Text) 1-800-846-5277 New Horizons Independent Living Center Video Phones (318) 459-9233

A proud partner of the American Job Center Network