Forms
Important forms and documents
Applications
- Older Individuals Who Are Blind Application (PDF) opens a new window
- Older Individuals Who Are Blind Application (Spanish) (PDF) opens a new window
- Older Individuals Who Are Blind Application (Chinese) (PDF) opens a new window
- Older Individuals Who Are Blind Application (Chinese Traditional) (PDF) opens a new window
- Older Individuals Who Are Blind Application (Tagalog) (PDF) opens a new window
- Older Individuals Who Are Blind Application (Korean) (PDF) opens a new window
Biennial Report
Client Satisfaction Surveys
Job Development Forms
English
- Job Development Intake Accept-Reject Form (08-01-2023) (DOCX) opens a new window
- Job Placement Plan Checklist (optional) (08-01-2023) (DOCX) opens a new window
- Job Placement Plan (08-01-2023) (DOCX) opens a new window
- Job Placement Services Report (08-01-2023) (DOCX) opens a new window
- Verification of Employment (08-01-2023) (DOCX) opens a new window
- 30 60 90 Verification of Employment and Job Retention (08-01-2023) (DOCX) opens a new window
- Job Fit Analysis Form- for SE (03-01-2024) (DOCX) opens a new window
- VR Contractor Travel Pre-Approval Reimbursement Form (6-11-24) (PDF) opens a new window
- Vendor Travel – Mileage Reimbursement Form (06-15-24) (PDF) opens a new window
- Job Developer Technical Guide-Revised (2-06-25) (PDF) opens a new window
Spanish
- Job Development Intake Accept-Reject Form (08-01-2023) (Spanish) (DOCX) opens a new window
- Job Placement Plan Checklist (optional) (Spanish) (08-01-2023) (DOCX) opens a new window
- Job Placement Plan (08-01-2023) (Spanish) (DOCX) opens a new window
- Job Placement Services Report (08-01-2023) (Spanish) (DOCX) opens a new window
- Verification of Employment (08-01-2023) (Spanish) (DOCX) opens a new window
- 30 60 90 Verification of Employment and Job Retention (Spanish) (DOCX) opens a new window
- Job Fit Analysis Form- for SE (03-01-2024) (Spanish) (DOCX) opens a new window
- VR Contractor Travel Pre-Approval Reimbursement Form (6-11-24) (Spanish) (PDF) opens a new window
- Job Developer Technical Guide-Revised (2-06-25) (Spanish) (PDF) opens a new window
Chinese Simplified
- Job Development Intake Accept-Reject Form (08-01-2023) (Chinese) (DOCX) opens a new window
- Job Placement Plan Checklist (optional) (Chinese) (08-01-2023) (DOCX) opens a new window
- Job Placement Plan (08-01-2023) (Chinese) (DOCX) opens a new window
- Job Placement Services Report (08-01-2023) (Chinese) (DOCX) opens a new window
- Verification of Employment (08-01-2023) (Chinese) (DOCX) opens a new window
- 30 60 90 Verification of Employment and Job Retention (Chinese) (DOCX) opens a new window
- Job Fit Analysis Form- for SE (03-01-2024) (Chinese) (DOCX) opens a new window
Chinese Traditional
- Job Development Intake Accept-Reject Form (08-01-2023) (Chinese Traditional) (DOCX) opens a new window
- Job Placement Plan Checklist (optional) (Chinese Traditional) (08-01-2023) (DOCX) opens a new window
- Job Placement Plan (08-01-2023) (Chinese Traditional) (DOCX) opens a new window
- Job Placement Services Report (08-01-2023) (Chinese Traditional) (DOCX) opens a new window
- Verification of Employment (08-01-2023) (Chinese Traditional) (DOCX) opens a new window
- 30 60 90 Verification of Employment and Job Retention (Chinese Traditional) (DOCX) opens a new window
- Job Fit Analysis Form- for SE (03-01-2024) (Chinese Traditional)) (DOCX) opens a new window
Tagalog
- Job Development Intake Accept-Reject Form (08-01-2023) (Tagalog) (DOCX) opens a new window
- Job Placement Plan Checklist (optional) (Tagalog) (08-01-2023) (DOCX) opens a new window
- Job Placement Plan (08-01-2023) (Tagalog) (DOCX) opens a new window
- Job Placement Services Report (08-01-2023) (Tagalog) (DOCX) opens a new window
- Verification of Employment (08-01-2023) (Tagalog) (DOCX) opens a new window
- 30 60 90 Verification of Employment and Job Retention (Tagalog) (DOCX) opens a new window
- Job Fit Analysis Form- for SE (03-01-2024) (Tagalog) (DOCX) opens a new window
Korean
- Job Development Intake Accept-Reject Form (08-01-2023) (Korean) (DOCX) opens a new window
- Job Placement Plan Checklist (optional) (Korean) (08-01-2023) (DOCX) opens a new window
- Job Placement Plan (08-01-2023) (Korean) (DOCX) opens a new window
- Job Placement Services Report (08-01-2023) (Korean) (DOCX) opens a new window
- Verification of Employment (08-01-2023) (Korean) (DOCX) opens a new window
- 30 60 90 Verification of Employment and Job Retention (Korean) (DOCX) opens a new window
- Job Fit Analysis Form- for SE (03-01-2024) (Korean) (DOCX) opens a new window
Community Based Assessment and Work Based Learning Experience Forms
English
- CBA Accept-Reject Form (03-01-2024) (DOCX) opens a new window
- CBA Job Duties (03-01-2024) (DOCX) opens a new window
- CBA Supervisor Weekly Report (03-01-2024) (DOCX) opens a new window
- CBA Weekly Monitoring Report (03-01-2024) (DOCX) opens a new window
- CBA Weekly Job Coaching Report (03-01-2024) (DOCX) opens a new window
- CBA Final Exit Summary Report (03-01-2024) (DOCX) opens a new window
- Work Experience and WBLE Forms (03-01-2024) (DOCX) opens a new window
Spanish
- CBA Accept-Reject Form (03-01-2024) (Spanish) (DOCX) opens a new window
- CBA Job Duties (03-01-2024) (Spanish) (DOCX) opens a new window
- CBA Supervisor Weekly Report (03-01-2024) (Spanish) (DOCX) opens a new window
- CBA Weekly Monitoring Report (03-01-2024) (Spanish) (DOCX) opens a new window
- CBA Weekly Job Coaching Report (03-01-2024) (Spanish) (DOCX) opens a new window
- CBA Final Exit Summary Report (03-01-2024) (Spanish) (DOCX) opens a new window
Chinese Simplified
- CBA Accept-Reject Form (03-01-2024) (Chinese) (DOCX) opens a new window
- CBA Job Duties (03-01-2024) (Chinese) (DOCX) opens a new window
- CBA Supervisor Weekly Report (03-01-2024) (Chinese) (DOCX) opens a new window
- CBA Weekly Monitoring Report (03-01-2024) (Chinese) (DOCX) opens a new window
- CBA Weekly Job Coaching Report (03-01-2024) (Chinese) (DOCX) opens a new window
- CBA Final Exit Summary Report (03-01-2024) (Chinese) (DOCX) opens a new window
Chinese Traditional)
- CBA Accept-Reject Form (03-01-2024) (Chinese Traditional) (DOCX) opens a new window
- CBA Job Duties (03-01-2024) (Chinese Traditional) (DOCX) opens a new window
- CBA Supervisor Weekly Report (03-01-2024) (Chinese Traditional) (DOCX) opens a new window
- CBA Weekly Monitoring Report (03-01-2024) (Chinese Traditional) (DOCX) opens a new window
- CBA Weekly Job Coaching Report (03-01-2024) (Chinese Traditional) (DOCX) opens a new window
- CBA Final Exit Summary Report (03-01-2024) (Chinese Traditional) (DOCX) opens a new window
Tagalog
- CBA Accept-Reject Form (03-01-2024) (Tagalog) (DOCX) opens a new window
- CBA Job Duties (03-01-2024) (Tagalog) (DOCX) opens a new window
- CBA Supervisor Weekly Report (03-01-2024) (Tagalog) (DOCX) opens a new window
- CBA Weekly Monitoring Report (03-01-2024) (Tagalog) (DOCX) opens a new window
- CBA Weekly Job Coaching Report (03-01-2024) (Tagalog) (DOCX) opens a new window
- CBA Final Exit Summary Report (03-01-2024) (Tagalog) (DOCX) opens a new window
Korean
- CBA Accept-Reject Form (03-01-2024) (Korean) (DOCX) opens a new window
- CBA Job Duties (03-01-2024) (Korean) (DOCX) opens a new window
- CBA Supervisor Weekly Report (03-01-2024) (Korean) (DOCX) opens a new window
- CBA Weekly Monitoring Report (03-01-2024) (Korean) (DOCX) opens a new window
- CBA Weekly Job Coaching Report (03-01-2024) (Korean) (DOCX) opens a new window
- CBA Final Exit Summary Report (03-01-2024) (Korean) (DOCX) opens a new window