Form 2.5 "In-school Youth Eligibility Determination for in-School Youth Program - Workforce Innovation and Opportunity Act (Wioa)" - Arkansas

What Is Form 2.5?

This is a legal form that was released by the Arkansas Department of Labor and Licensing - Division of Workforce Services - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 24, 2021;
  • The latest edition provided by the Arkansas Department of Labor and Licensing - Division of Workforce Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 2.5 by clicking the link below or browse more documents and templates provided by the Arkansas Department of Labor and Licensing - Division of Workforce Services.

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Download Form 2.5 "In-school Youth Eligibility Determination for in-School Youth Program - Workforce Innovation and Opportunity Act (Wioa)" - Arkansas

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In-School Youth Eligibility Determination
)
Workforce Innovation and Opportunity Act (WIOA
FORM WIOA I-B – 2.5 (6/24/21)
For In-School Youth Program
Name:
Participant No.:
In-School Youth Eligibility
Documentation
Applicant must meet age, common eligibility,
Check appropriate documentation used
low-income, school status requirements, and at
(Only one document required per eligibility
least one barrier
criterion)
In addition, priority is given to veterans and
Must maintain copies of all documents used
populations identified by local area
See Date of Birth on FORM WIOA I-B – 2.1
At least age 14, and not older than 21
(Common Eligibility Documentation)
Use FORM WIOA I-B – 2.1 (Common Eligibility
Meet common eligibility requirements
Documentation)
Use FORM WIOA I-B – 1.3 (Low-Income
Low-income individual
Documentation)
Cross-Match with Postsecondary Education
Attending school
PIRL #409
Database
Name of school:
Educational Institution Enrollment Record Copy
in-school, secondary school or less (no
Applicable Records from Education Institution
secondary diploma or equivalent)
(GED certificate, diploma, attendance records,
in school, postsecondary school (has high
transcripts, report card, or school
school diploma or equivalent)
documentation)
Intake Application or Enrollment Form Signed
Self-Attestation
Use FORM WIOA I-B – 2.2 (Veteran Priority
Veteran or eligible spouse
Documentation)
****Must provide documentation for at least one barrier for eligibility.
Additional barriers may be reported using self-attestation on the application****
Basic Skills Deficient Categories (choose
Category 1, 2 or 3)
Note: if assessment and/or testing reveals that a
person is basic skills deficient (BSD) for either
Category 1: A youth who has English reading,
th
category, then the BSD question on the snapshot
writing, or computing skills at or below the 8
must be “yes”.
grade level on a generally accepted
standardized test. The State of Arkansas
interprets this criterion to mean scoring at or
below Grade Level 8.9.
PIRL #804
Form 2.5 (6/24/21)
In-School Youth Eligibility Determination
Page 1
A proud partner of American Job Center
In-School Youth Eligibility Determination
)
Workforce Innovation and Opportunity Act (WIOA
FORM WIOA I-B – 2.5 (6/24/21)
For In-School Youth Program
Name:
Participant No.:
In-School Youth Eligibility
Documentation
Applicant must meet age, common eligibility,
Check appropriate documentation used
low-income, school status requirements, and at
(Only one document required per eligibility
least one barrier
criterion)
In addition, priority is given to veterans and
Must maintain copies of all documents used
populations identified by local area
See Date of Birth on FORM WIOA I-B – 2.1
At least age 14, and not older than 21
(Common Eligibility Documentation)
Use FORM WIOA I-B – 2.1 (Common Eligibility
Meet common eligibility requirements
Documentation)
Use FORM WIOA I-B – 1.3 (Low-Income
Low-income individual
Documentation)
Cross-Match with Postsecondary Education
Attending school
PIRL #409
Database
Name of school:
Educational Institution Enrollment Record Copy
in-school, secondary school or less (no
Applicable Records from Education Institution
secondary diploma or equivalent)
(GED certificate, diploma, attendance records,
in school, postsecondary school (has high
transcripts, report card, or school
school diploma or equivalent)
documentation)
Intake Application or Enrollment Form Signed
Self-Attestation
Use FORM WIOA I-B – 2.2 (Veteran Priority
Veteran or eligible spouse
Documentation)
****Must provide documentation for at least one barrier for eligibility.
Additional barriers may be reported using self-attestation on the application****
Basic Skills Deficient Categories (choose
Category 1, 2 or 3)
Note: if assessment and/or testing reveals that a
person is basic skills deficient (BSD) for either
Category 1: A youth who has English reading,
th
category, then the BSD question on the snapshot
writing, or computing skills at or below the 8
must be “yes”.
grade level on a generally accepted
standardized test. The State of Arkansas
interprets this criterion to mean scoring at or
below Grade Level 8.9.
PIRL #804
Form 2.5 (6/24/21)
In-School Youth Eligibility Determination
Page 1
A proud partner of American Job Center
Category 2: unable to compute or solve
Documentation for Categories 1 & 2:
problems, or read, write, or speaking English
Case notes
at a level necessary to function on the job, in
Assessment Test Results
the individual’s family, or in society (choose
Applicable Records from Education
and document ONE of the following)
Institution (transcripts, academic
PIRL #804
assessments, or other school
documentation)
Unable to speak English well enough to
conduct a normal conversation with or
Category 1 - Record the levels, if desired
follow the instructions of an English-
Document scoring 8.9 or below on an
speaker
appropriate standardized test administered
Unable to read English well enough to
within the last 6 months
follow written instructions, including a
Test: ___________________________
manual or a recipe
Given by: ________________________
Unable to read and write well enough to
Date: ____________
read and appropriately complete an
application for services or an application
Reading: _________ Math: _________
for employment
Unable to pass a driver’s license test
Category 1 - Record the levels, if desired
written in English
School documents giving current grade-level
Unable to make change or determine if
equivalency of youth’s abilities (in last 6
correct change was given from a clerk
months)
An adult who lacks the basic academic
Document: ________________________
skills needed to obtain a job at above
Date: ____________
minimum wage, as evidenced by the
Reading: _________ Math: _________
adult’s employment history
A high-school dropout who had no
education past the eighth grade
Documentation for Category 3
:
Category 3: English Language Learner - Document
(A) and either (B) or (C):
Case notes
PIRL #803
Assessment Test Results
(A) Limited ability to read, write, speak or
Applicable Records from Education
comprehend the English language
Institution (transcripts, or other school
documentation)
(B) Native language is a language other than
Self-Attestation
English
Intake Application or Enrollment Form
(C) Lives in a family or community
Signed
environment where a language other than
English is the dominant language
Offender or ex-offender: PIRL #801
Documentation from criminal justice system
(Is or has been subject to any stage of criminal
Telephone verification with court or
justice process for committing a status offense
probation representatives
or delinquent act OR requires assistance in
overcoming barriers to employment because
Self-attestation with sufficient information to
of arrest or conviction)
describe situation
Form 2.5 (6/24/21)
In-School Youth Eligibility Determination
Page 2
A proud partner of American Job Center
Document Homeless Individual in FORM WIOA I-
Homeless individual
B – 1.3 (Low-Income Documentation)
Document under Homeless Individual in FORM
Runaway
WIOA I-B – 1.3 (Low-Income Documentation)
Note: A runaway is also classified as homeless
.
[TEGL 22-15]
Written Confirmation from Social Services
Foster Care Youth
Agency
PIRL #704
Case Notes
Self-Attestation
Youth is aged 24 or under who is currently in
Foster Care Agency Referral Transmittal
foster care or has aged out of the foster care
Intake Application or Enrollment Form Signed
system
Needs Assessment
IEP/ISS Signed
Self-Attestation
Pregnant or Parenting Youth (male or
Case Notes
female; single or married; custodial or
Needs Assessment
non-custodial)
WIC Eligibility Verification
PIRL #701
TANF Single Parent Eligibility Verification
Intake Application or Enrollment Form
Signed
ISS Signed
Self-Attestation
Individual with a disability
School 504 Records Provided by Student
PIRL #202
Assessment Test Results
(Disability documents must be kept confidential)
Documentation identified by LWDB, but suggested
Youth Who Needs Additional Assistance
documentation include:
PIRL #702
Self-Attestation
Intake Application or Enrollment Form Signed
Case Notes
Needs Assessment
ISS Signed
Date of eligibility determination:
Staff completing form:
Form 2.5 (6/24/21)
In-School Youth Eligibility Determination
Page 3
A proud partner of American Job Center
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