Page 687

VIRGINIA DEPARTMENT OF SOCIAL SERVICES SNAP E&T Job Search Form

10/24 VOLUME V, PART XXV, APPENDIX II, PAGE 21

SNAP E&T SUPERVISED JOB SEARCH FORM

FORM NUMBER - 032-02-1030

PURPOSE OF FORM - This form provides written documentation of the SNAP E&T participant’s supervised job search contacts.

USE OF FORM - This form is used by SNAP E&T and VIEW participants to record employer contacts, contact hours and outcomes during assignment to a job search component.

NUMBER OF COPIES - One

DISPOSITION OF COPIES - Original becomes a part of the case record when the participant completes job search and returns the form.

INSTRUCTIONS FOR PREPARING FORM:

The first section of the form is completed by the Employment Services Worker (ESW) and the information is discussed with the participant. After the form is returned by the participant, the ESW will fill in the number of contacts for the month (SNAP E&T only) or Assigned hours for the month, the Holiday hours used for the month, the Excused Absence hours used for the month, and the Total Countable hours of participation for this activity for the month (VIEW only).

The “Employer Contact List” is completed by the participant. Employers are not required to sign the form. The first box in the contacts section is to record the mandatory registration/contact with the Virginia Workforce Connection for both VIEW and SNAP E&T participants. At the end of the job search assignment or at a time designated by the Employment Services Worker, the form is to be returned to the agency. The Employment Services Worker will explain to the participant how the form is to be returned.

The participant will sign the form at the bottom of each page indicating that the contacts have actually been made and that contacts or hours are accurate. A statement on the form cautions the participant that the Employment Services Worker may contact the employer to verify the contact.

TRANSMITTAL #35