LEADS Workforce Development Application

LEADS Application (2)

  • LEADS Application

    Leadership, Education, Action, Development, and Sustainability
  • MM slash DD slash YYYY
  • Education

  • e.g, 2004-2008
  • e.g, 2004-2008
  • e.g, 2004-2008
  • Employment

  • e.g., employed from December 2017 to March 2019
  • Financial Literacy Course Interst

    Delta Health Alliance’s Financial Literacy Class teaches participants about money management and provides tools and strategies to promote wealth building. The curriculum covers various topics including managing finances, reducing debt, saving habits, establishing or re-establishing credit to aim at building financial confidence.
  • Program Interest

    What programs are you interested in? Choose from one of the following drop down menus.
    Check all that apply.
  • References

    Please list two references (no family members).
  • Clear Signature
  • MM slash DD slash YYYY

To participate, you must be authorized to work in the United States and live in one of the service counties. Please provide a valid REAL driver’s license or ID (to verify the county of residence) and a copy of your Social Security Card or other proof of work authorization documents.

Acceptable list of work authorization documents:

  • Social Security Card
  • US Passport or US Passport Card
  • Permanent Resident Card (Form I-551)
  • Employment Authorization Document (EAD, Form I-766) with photo
  • Federal, state, or local government ID card with photo
  • School ID card with photo

Commonly accepted income verification documents:

  • Pay stubs (most recent month)
  • Employer statement/wage verification form
  • W-2 form or 1099
  • Federal income tax return (most recent year)
  • Public assistance benefit letter or award notice
  • Unemployment benefit statement
  • Public assistance check
  • Child support payment documentation
  • Alimony payment records
  • Bank statements showing direct deposits (when tied to benefits or regular wages)
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