New Submission

Workforce Solutions Southeast Texas offers scholarships for training and education. Please complete the WIOA (Workforce Innovation and Opportunity Act) application below to see if you qualify. Let us help you achieve your job and career goals!
Are you eligible to work in the U.S.?*field type radio button
Are you eligible to work in the U.S.?YesNo
Based on your selection(s) above, you do not qualify at this time for training scholarships offered by the WIOA Program.
Do you live in Jefferson, Orange, or Hardin county?*field type radio button
Do you live in Jefferson, Orange, or Hardin county?YesNo
This form is intended for residents of Jefferson, Orange or Hardin counties. Find your local Workforce Solutions to find out if you qualify for training in your area.
Please select your preferred location for your follow up appointment with Workforce Solutions:*field type radio button
Please select your preferred location for your follow up appointment with Workforce Solutions:Beaumont WFC, 510 Park St., St. 200, 77701Port Arthur WFC, 4680 FM 365, 77642Orange WFC, 2415 N 16th Street, 77630Silsbee WFC, Silsbee Public Library, 295 N 4th St, 77656
Do you fall into one of the following groups?*field type checkbox
(check any/all that apply, if yes to any continue to consent form) If you do not know your household income, but would like to learn more, please complete the rest of the form and check the “None of the above / don’t know” box.)
Do you fall into one of the following groups?Family Size 1 and income not exceeding $12,880Family Size 2 and income not exceeding $17,420Family Size 3 and income not exceeding $22,258Family Size 4 and income not exceeding $27,479Family Size 5 and income not exceeding $32,432Family Size 6 and income not exceeding $37,931Family Size 7 and income not exceeding $43,430Family Size 8 and income not exceeding $48,929Family Size 9 and income not exceeding $54,428Family Size 10 and income not exceeding $59,927Receives or received in the last 6 months TANF, SNAP or SSIFoster youth, as defined by the Texas Family CodeVeteran or Eligible SpouseRecently terminated, laid-off, or received notice of layoff from employment without faultNone of the above / don’t know
Do you have children under the age of 13?*field type radio button
Do you have children under the age of 13?YesNo
If yes, check out our childcare services at: https://www.workforcechildcare.org/

Personal Information

First Name:*field type single line
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Middle Name:field type single line
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Last Name:*field type single line
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Suffix:field type drop-down
SSN: (last 4)*field type single line
enter last 4 digits of your SSN only
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Email:field type single line
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Verify Email:field type single line
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Phone Number:*field type single line
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Cell Number:field type single line
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Homeless:field type checkbox
Homeless:I am homeless

Address:

Street Address:*field type single line
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City:*field type single line
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State:*field type drop-down
ZIP:*field type single line
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Other Personal Info

Gender:*field type drop-down
Date of Birth:*field type date
Marital Status:*field type drop-down
Race:*field type checkbox
Race:WhiteBlack or African AmericanAmerican Indian or Alaskan NativeAsianHawaiian Native or Pacific Islander
Hispanic/Latino:*field type radio button
Hispanic/Latino:YesNo
Are you age 16 to 24?*field type radio button
Are you age 16 to 24?YesNo
CONSENT
By submitting this form, I consent to release information I have provided in this form to Workforce Solutions Southeast Texas staff in order to receive a follow-up. I understand that the requested information is to be used to connect me to a case manager who will then assist me in determining eligibility and applying for scholarship funds and other services where appropriate to enable me to complete workforce training. I further understand that this information will be kept strictly confidential by all parties to whom access is granted.
Additional Important Information Below:

Documents Needed for Your Initial Appointment
I-9 DOCUMENTS: Typically a Passport OR A valid Driver’s License AND a signed Social Security Card are utilized.
PROOF OF RESIDENCY IN JEFFERSON, ORANGE, OR HARDIN COUNTY: Voter registration card, lease agreement, utility bill, or a statement from your landlord with the address indicated.
SELECTIVE SERVICE REGISTRATION (MALES ONLY): Found at https://www.sss.gov/Home/Verification if you do not have a copy of the letter in your possession.
INCOME VERIFICATION:
- 6 Months of Pay Stubs (as of yesterday, ex. If today is November 4, 2019, we are looking for 6 months of pay stubs from May 4, 2019. We are looking to determine income from May 4, 2019 – November 4, 2019).
- If providing pay stubs, proof of income is required for applicant AND all included family members.
- Please include ALL wage earners showing income in the HOUSEHOLD for the last 6 months.
IF YOU ARE RECEIVING UNEMPLOYMENT:
- Letter of Separation
- Verification of Unemployment Benefits
- U.I. Summary of payments
IF APPLICABLE:
- SNAP Award Letter proving that you have received within the last 6 months or currently receiving
- TANF Award Letter proving that you have received within the last 6 months or currently receiving

WIOA Eligibility Application

Personal Information

Address:

Other Personal Info