Commissioner-Approved Training

• Name

• Social Security or Identification number

• Telephone number

• Claimant’s name and address:

• School name:

• School address:

• School counselor or contact name:

• Counselor or contact phone number:

• Please list the name of your training program or major as listed in your training provider’s course catalogue.

• I am a freshman

  freshman · sophomore · junior · senior · other

• other · if it applies

• What certificate or degree are you pursuing?

• When did you originally begin or when will you begin this training program?

• When did you register for this quarter or term?

• Classes began this quarter or term on:

• Classes will end this quarter or term on:

• When will you complete or graduate from the training program?

• Does the school or training program consider this training full-time or part-time?

  F/T · P/T

• online · optional

• in-person · optional

• correspondence · optional

• other · optional

• other, please explain: · if it applies

• Are you required to attend on specific days and at certain times?

  Yes · No

• How many hours do you spend or will you spend in class, class preparation and study each day?

• Grant: · optional

• Gift: · optional

• Scholarship: · optional

• Personal loan: · optional

• Student loan: · optional

• Out of pocket: · optional

• Other: · optional

• Grant: · if it applies

• Gift: · if it applies

• Scholarship: · if it applies

• Personal loan: · if it applies

• Student loan: · if it applies

• Out of pocket: · if it applies

• Other: · if it applies

• Would you have to return any of the money if you were to drop any of your classes?

  Yes · No

• List the occupation you have the most experience in:

• How many years?

• List any other significant occupations and years of experience:

• In the past, have you worked full-time while attending school?

  Yes · No

• If yes, how were you able to manage it? · if it applies

• Did you look for work or participate in any job-search activities through your WorkSource employment center during the last week you claimed?

  Yes · No

• If no, explain why: · if it applies

• What will you tell employers about your availability for work when you apply for or are offered a job?

• Su · optional

• M · optional

• Tu · optional

• W · optional

• Th · optional

• F · optional

• Sa · optional

• days · optional

• swing · optional

• graveyard · optional

• hours per day

• days per week

• If you were offered work that conflicts with your class schedule, would you drop the classes to accept the job?

  Yes · No

• Please explain your answer:

• Are your classes available other hours and will the school let you change at this stage of the school term?

  Yes · No

• Are you willing to forfeit your tuition if the school will not give you a refund?

  Yes · No

• Your signature · optional

• Date · optional

• Your telephone number:

• Email address (optional) · optional

• Do you have any degrees or certificates?

  Yes · No

• If yes, what are they and what year did you receive them? · if it applies

• List specific jobs you will be qualified to do after you complete training:

• If these jobs are not available where you live, will you move to another area to accept work?

  Yes · No

• If yes, what areas? · if it applies

• How will you pay for school and school-related expenses if your unemployment benefits run out before training ends?

• Is this training funded or sponsored under a special grant or program, such as Workforce Investment Act (WIA), Trade Act or Worker Retraining?

  Yes · No

• Counselor's name: · if it applies

• Phone number: · if it applies

• Location: · if it applies

• Name of special grant and program: · if it applies

• Does your union or employer require this training?

  Yes · No

• If yes, provide union or employer name and phone number. · if it applies

• Did you receive a Worker Adjustment and Retraining Notice (WARN)?

  Yes · No

• If yes, when and from which employer? · if it applies

• Have employers said you need updated skills or certification to continue working in your main occupation?

  Yes · No

• If yes, please explain: · if it applies

• Do you have any injuries, illnesses, or other conditions that prevent you from returning to your main occupation?

  Yes · No

• If yes, please explain: · if it applies

• Signature · optional

• Date · optional

What is your class schedule this quarter or term?: answered for each person (Class name, Course number, Credit hours, Class times, Class days).

List your last three jobs beginning with the most recent:: answered for each person (Business name, Occupation, Start date, End date).

If yes, list contacts made:: answered for each person (Date, Employer name /Activity, Employer / WorkSource address, Position).

• WorkSource can help research occupations and review the application for completion.
• After approval, stay enrolled full time, make satisfactory progress and submit the progress reports ESD sends.
• Tell ESD if you stop training, take a break, change the program or provider, or reduce attendance below full time.
• You may request a telephone or in-person interview before ESD decides. You may have someone assist you and present evidence or witnesses.
• ESD decides whether you qualify for CAT. Approval waives job search during training.
• If training requirements are not met, you may need to look for work or repay benefits.
• ESD sends its decision letter through eServices or by mail.
• ESD will contact you if it needs additional information.

• Keep seeking work until ESD tells you CAT is approved.
• If you are completing a separate Training Benefits application, you do not need to complete the student eligibility questionnaire.
• To train to set up your own business, apply through SEAP instead of this form.
• Plan how to finish school if benefits run out. CAT does not add weeks or pay school costs.
• Return the completed form. ESD may deny benefits or find an overpayment if it is not returned.

• ESD publishes mail and fax application instructions. No separate CAT application deadline or fixed calendar window is stated.
• Some details here could not be confirmed. Check with Washington State Employment Security Department before you apply.