This document must be completed and submitted to Lorraine Wareham at prior to entering into or implementing any agreement(s) with a company(ies) for incumbent worker training. The Grantee may proceed with this project once approval has been obtained from the Department of Commerce. Date Submitted: Name of Employer: Grantee: Employer Sector / Industry: Grant Number: Total Number of Employees at Work Site: Project Name: Number of Employees to be Trained: Training Cost: Start/End Date of Training: Project Cost: Participant will Receive (if different than the training cost) Training Only Industry Recognized Certificate or Credential 1 the Incumbent Worker indicator(s) below that are applicable for this company: – “at-risk” (More than one may be checked check as many as applicable. See pages 2 and 3 of this document for – descriptions of the at-risk indicators) Below each at-risk indicator that is checked, you must provide specific/detailed information/discussion that supports the indicator as the factor on which the Incumbent Worker strategy is, or will be based. “at-risk” Declining Sales Supply Chain Issues Adverse Industry / Market Trends Changes in Management Philosophy or Ownership Worker Does Not Have In-Demand Skills Strong Possibility of a Job if a Worker Attains New Skills Other Indicators “at-risk” 2 Describe how that training will address the indicator(s) identified above and explain how the – “at-risk” training will result in averting the layoff of employees. 3 If the Grantee is not the training provider, discuss who will be providing the training, and if not – provided in-house, confirm that the trainer selected or to be selected used an appropriate procurement process. If more than one training provider is used, describe the specific responsibilities of each.
This document must be completed and submitted to Lorraine Wareham at prior to entering into or implementing any agreement(s) with a company(ies) for incumbent worker training. The Grantee may proceed with this project once approval has been obtained from the Department of Commerce. Date Submitted: Name of Employer: Grantee: Employer Sector / Industry: Grant Number: Total Number of Employees at Work Site: Project Name: Number of Employees to be Trained: Training Cost: Start/End Date of Training: Project Cost: (if different than the training cost) Participant will Receive Training Only Industry Recognized Certificate or Credential 1 – the Incumbent Worker “at-risk” indicator(s) below that are applicable for this company: (More than one may be checked – check as many as applicable. See pages 2 and 3 of this document for descriptions of the at-risk indicators) Below each at-risk indicator that is checked, you must provide specific/detailed information/discussion that supports the “at-risk” indicator as the factor on which the Incumbent Worker strategy is, or will be based. Declining Sales Supply Chain Issues Adverse Industry / Market Trends Changes in Management Philosophy or Ownership Worker Does Not Have In-Demand Skills Strong Possibility of a Job if a Worker Attains New Skills Other “at-risk” Indicators 2 – Describe how that training will address the “at-risk” indicator(s) identified above and explain how the training will result in averting the layoff of employees. 3 – If the Grantee is not the training provider, discuss who will be providing the training, and if not provided in-house, confirm that the trainer selected or to be selected used an appropriate procurement process. If more than one training provider is used, describe the specific responsibilities of each.
At-Risk%20Documentation%20Form%20-Final-%20120315.docx