Fillable WORKFORCE SERVICES WORK-BASED TRAINING PLAN AGREEMENT (South Dakota DLR)

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WORKFORCE SERVICES WORK-BASED TRAINING PLAN AGREEMENT (South Dakota DLR)

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The WORKFORCE SERVICES WORK-BASED TRAINING PLAN AGREEMENT (South Dakota DLR) form is 5 pages long and contains:

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  • 49 check-boxes
  • 118 other fields

Country of origin: US
File type: PDF

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South Dakota Department of Labor & Regulation (DLRA) aim to promote economic opportunity and financial security in the South Dakota. They support individuals and businesses through expert services, employment solutions and business practices.

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DLR WIOA – Section 10 – Form 19 WORK-BASED TRAINING PLAN AGREEMENT
REV 2/2021
SOUTH DAKOTA DEPARTMENT OF LABOR AND REGULATION
WORKFORCE SERVICES
sdjobs.org
WORK-BASED TRAINING PLAN AGREEMENT
PARTICIPANT INFORMATION
NAME: SDWORKS ID: PROGRAM:
WORK-BASED LEARNING EXPERIENCE INFORMATION
BUSINESS NAME (must match SDWORKS): JOB TITLE:
START DATE: END DA
TE: PAID UNPAID
WORK EXPERIENCE ON-THE-JOB TRAINING
TOTAL HOURS
HOURLY RATE
TOTAL HOURS
x HOURLY RATE
x 0.5
= OJT REIMBURSEMENT
TRAINING PLAN INFORMATION
SKILL AREA(S):
WorkKeys Categories, O*Net Knowledge, Skills, Work Activities/Context, etc.
TRAINING METHOD
MANUALS
VIDEO
COMPUTER-BASED
DEMONSTRATION
OTHER: ____________________
SKILL AREA(S):
TRAINING METHOD
MANUALS
VIDEO
COMPUTER-BASED
DEMONSTRATION
OTHER: ____________________
SKILL AREA(S):
TRAINING METHOD
MANUALS
VIDEO
COMPUTER-BASED
DEMONSTRATION
OTHER: ____________________
(select one)
.5
$ 0.00
DLR WIOA – Section 10 – Form 19 WORK-BASED TRAINING PLAN AGREEMENT
SKILL AREA(S):
TRAINING METHOD
MANUALS
VIDEO
COMPUTER-BASED
DEMONSTRATION
OTHER: ____________________
SKILL AREA(S):
TRAINING METHOD
MANUALS
VIDEO
COMPUTER-BASED
DEMONSTRATION
OTHER: ____________________
AGREEMENT AND ACKNOWLEDGEMENT
Each checked box indicates all parties acknowledge and agree to the following:
All DLR paperwork must be completed before starting a new position.
Work Experiences are limited to 25 hours per week.
DLR will not pay overtime for individuals on On-the-Job Training.
DLR will not pay for hours exceeding the total hours listed in the WORK-BASED LEARNING EXPERIENCE section.
DLR will complete monitors to ensure progress is being made towards the training plan.
The individual must conduct themselves responsibly and courteously, follow the policies of the workplace, and work as
scheduled.
If the individual does not meet the needs of the workplace, they may be terminated.
BUSINESS REPRESENTATIVE(S)
NAME: SIGNATURE: DATE:
NAME: SIGNATURE: DATE:
PARTICIPANT
SIGNATURE: DATE:
DLR REPRESENTATIVE
NAME: SIGNATURE: DATE
:
* One of the business representatives listed below must match the signatory on the WEX Timecard (WIOA Form 18) or OJT Timecard (WIOA Form 20).
Participant's Emergency Contact
Name ______________________________ Relationship ______________ Phone ___________________
Name ______________________________ Relationship ______________ Phone ___________________
By signing below, all parties indicate the training plan was developed jointly and ensures appropriate skill development for the assigned job.
DLR WIOA – Section 10 – Form 19B
M
ONITOR
REV 2/2021
SOUTH DAKOTA DEPARTMENT OF LABOR AND REGULATION
WORKFORCE SERVICES
sdjobs.org
WORK-BASED TRAINING MONITOR
PARTICIPANT INFORMATION
NAME: SDWORKS ID: PROGRAM:
TRAINING PLAN INFORMATION
BUSINESS NAME (must match SDWORKS): JOB TITLE:
WORK EXPERIENCE ON-T
HE-JOB TRAINING UNPAID BUSINESS PAID
MONITOR INFORMATION
TYPE: INITIAL INTERIM _____ HRS FINAL _____ HRS COMPLETED
INDIVIDUALS: PARTICIPANT BUSINESS REP. TRAINING SUPERVISOR
CONTACT METHOD: IN-PERSON PHONE EMAIL OTHER
PARTICIPANT: CONTINUED COMPLETED HIRED TERMINATED
MONITOR SKILL AREAS
* Each Skill Area must have one indicator check-marked (each) for Progress and Performance.
SKILL AREA(S):
PROGRESS
Training has not started
Training in progress
Training completed
PERFORMANCE
Doing well
Shows improvement
Needs improvement
N/A (if training has not started)
SKILL AREA(S):
PROGRESS
Training has not started
Training in progress
Training completed
PERFORMANCE
Doing well
Shows improvement
Needs improvement
N/A (if training has not started)
(select one)
DLR WIOA – Section 10 – Form 19
M
ONITOR
SKILL AREA(S):
PROGRESS
Training has not started
Training in progress
Training completed
PERFORMANCE
Doing well
Shows improvement
Needs improvement
N/A (if training has not started)
SKILL AREA(S):
PROGRESS
Training has not started
Training in progress
Training completed
PERFORMANCE
Doing well
Shows improvement
Needs improvement
N/A (if training has not started)
SKILL AREA(S):
PROGRESS
Training has not started
Training in progress
Training completed
PERFORMANCE
Doing well
Shows improvement
Needs improvement
N/A (if training has not started)
ACKNOWLEDGEMENT
By signing below, all parties acknowledge the discussion regarding performance and the comments within this monitor. Signatures do not
indicate agreement.
BUSINESS REPRESENTATIVE(S)
* One of the business representatives listed below must match the signatory on the WEX Timecard (WIOA Form 18) or OJT Timecard (WIOA Form 20).
NAME: SIGNATURE: DATE:
NAME: SIGNATURE: DATE:
PARTICIPANT
SIGNATURE: DATE:
DLR REPRESENTATIVE
NAME: SIGNATURE: DATE
:
DLR Copy (upload into SDWORKS)
Business Copy
MONITOR
Participant Copy
ADDITIONAL COMMENTS
PARTICIPANT COMMENTS BUSINESS COMMENTS
DLR WIOA – Section 10 – Form
19
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WORKFORCE SERVICES WORK-BASED TRAINING PLAN AGREEMENT (South Dakota DLR)

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Completed 14 February 2021

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