Fillable hank you for your expressed interest in serving (Hennepin County)

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hank you for your expressed interest in serving (Hennepin County)

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_____________________________________
Serving communities of suburban Hennepin and Carver counties
T
hank you for your expressed interest in serving on the Hennepin Carver Workforce Development Board (HC
WDB). We value your interest and expressed commitment to workforce development within our service area.
Please complete the following information as it relates to the Government and Economic Development
organization you represent.
Applicant Information
Applicant Name:
Applicant Address:
Applicant Phone Number:
Applicant Email Address:
Applicant Position Title:
Organization Name:
Organization Address:
HC WDB Term of Service:
Go
vernment & Economic Development Category
Is the organization you represent an economic and community development organization?
☐Yes ☐No
OR
I
s the organization you represent the State Employment Service office under the Wagner – Peyser Act serving
WDA 09?
☐Yes ☐No
OR
Is the organization you represent the Vocational Rehabilitation program carried out under Title I of the
Rehabilitation Act of 1973, other than sec. 112 or part C of that title?
☐Yes ☐No
P
lease identify who recommends/nominates you to serve on this board as a government and economic
development representative:
Name: _____________________________________________________
Agency: _____________________________________________________
Position: _____________________________________________________
_____________________________________
Serving communities of suburban Hennepin and Carver counties
Address: _____________________________________________________
Phone: _____________________________________________________
Government and Economic Development representatives are appointed from among individuals who are
nominated by government or economic development entities.
Overview & Definitions
Governance of the Hennepin-Carver Workforce Development Board
Chief local elected officials are required by law to establish a formal nomination and appointment process,
consistent with the criteria established by the Governor and State WDB under sec. 107(b)(1) of WIOA. For
Workforce Development Area (WDA) 9 of Suburban Hennepin & Carver Counties. For WDA 9, the chief local
elected official is the Hennepin County board, and by extension, the chair of the board.
G
overnment and Economic Development Seats Essential Requirements
Must include 1 representative from each of the following
1
:
1. Economic and community development organizations
2. The State Employment Service office under the Wagner-Peyser Act serving the local area
3. The programs carried out under title I of the Rehabilitation Act of 1973, other than sec. 112 or part C
of that title;
Thank you again for your time and consideration. If you have any further questions please contact Anne Kilzer at 612-
or via email at anne.kilzer@hennepin.us
1
WIOA Section 107(b)(2)(D) and Minn. Statute § 116L.666, Subd. 3
Describe your experience relating to the position:
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hank you for your expressed interest in serving (Hennepin County)

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Completed 24 December 2020

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