"Job Development Services Intake Accept/Reject Form" - Nevada

Job Development Services Intake Accept/Reject Form is a legal document that was released by the Nevada Department of Employment, Training and Rehabilitation - a government authority operating within Nevada.

Form Details:

  • Released on November 1, 2018;
  • The latest edition currently provided by the Nevada Department of Employment, Training and Rehabilitation;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Nevada Department of Employment, Training and Rehabilitation.

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Download "Job Development Services Intake Accept/Reject Form" - Nevada

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State of Nevada Bureau of Vocational Rehabilitation
Job Development Services Intake Accept/Reject
Contractor Name:
Participant Name:
Contractor Company:
Case ID#:
Contractor Phone:
Rehabilitation Counselor:
Contractor Email:
Date of Meeting:
Contractor Decision:
☐ I have completed the Intake Meeting and agree to provide requested and authorized job
Accept:
development services for this participant. I will jointly develop an individualized job placement
plan followed by the provision of significant job placement services if the participant choses to hire
me
☐ I have completed the Intake Meeting and decline to provide job development services for this
Reject:
participant at this time for the following reason(s):
Participant Decision:
☐ I request this contractor provide me job placement assistance. I understand my contractor and I
Accept:
will work together to develop a job placement plan that takes into account my abilities as well as
job placement needs. The job placement plan will include both my responsibilities and the
contractor’s responsibilities in helping me find employment. I will put forth good effort in my job
search.
☐ I have met with and decline services from this contractor at this time for the following reason(s):
Reject:
Contractor
Signature:
Date:
Participant/Representative Signature:
Date:
Please submit the completed form to the Business Development Team at businessdevelopment@detr.nv.gov
November 2018
State of Nevada Bureau of Vocational Rehabilitation
Job Development Services Intake Accept/Reject
Contractor Name:
Participant Name:
Contractor Company:
Case ID#:
Contractor Phone:
Rehabilitation Counselor:
Contractor Email:
Date of Meeting:
Contractor Decision:
☐ I have completed the Intake Meeting and agree to provide requested and authorized job
Accept:
development services for this participant. I will jointly develop an individualized job placement
plan followed by the provision of significant job placement services if the participant choses to hire
me
☐ I have completed the Intake Meeting and decline to provide job development services for this
Reject:
participant at this time for the following reason(s):
Participant Decision:
☐ I request this contractor provide me job placement assistance. I understand my contractor and I
Accept:
will work together to develop a job placement plan that takes into account my abilities as well as
job placement needs. The job placement plan will include both my responsibilities and the
contractor’s responsibilities in helping me find employment. I will put forth good effort in my job
search.
☐ I have met with and decline services from this contractor at this time for the following reason(s):
Reject:
Contractor
Signature:
Date:
Participant/Representative Signature:
Date:
Please submit the completed form to the Business Development Team at businessdevelopment@detr.nv.gov
November 2018