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VIRGINIA DEPARTMENT SNAP E&T And View OF SOCIAL SERVICES Referral to Work Site

10/24 VOLUME V, PART XXV, APPENDIX II, PAGE 25

SNAP E&T AND VIEW REFERRAL TO WORK SITE (FEP, CWEP, PSP, Work Experience)

FORM NUMBER - 032-02-1060

PURPOSE OF FORM - This form provides the SNAP E&T and VIEW participant and the CWEP, PSP or Work Experience work site or FEP employer with written information about the SNAP E&T or VIEW participant’s assignment to or interview at the work site.

USE OF FORM - The form is used to refer SNAP E&T or VIEW participants to a CWEP, PSP or Work Experience work site or FEP placement to interview for a position.

NUMBER OF COPIES - Three

DISPOSITION OF COPIES - Original – Participant 1st copy – Work Site 2nd copy – Case Record

INSTRUCTIONS FOR PREPARATION OF FORM:

Preparation of this form will serve to refer the SNAP E&T or VIEW participant for an interview or an assignment to a work experience or FEP position for which there is a position description on file.

The first section of the form contains information that the SNAP E&T or VIEW participant will use to locate the site, to call the worker/case manager if a problem arises, and to understand the nature of the position for which they are being interviewed or to which they are being assigned.

The second and third sections of the form also contain information which will help the work site representative interview the SNAP E&T or VIEW participant, record the details of the position for which the SNAP E&T or VIEW participant is applying/reporting, and know who the local agency contact person is for this particular SNAP E&T or VIEW participant.

All sections of the form need to be completed for all parties to understand the referral.

TRANSMITTAL #35