Adding New Career Services Courses

Is this a new provider? Yes / No

If yes:

Provider [i.e., business name]:

Site Name(s) [i.e. name(s) used for referrals]:

Please also add the site phone #s, if available

Project: (i.e., SOR or MADOC)

Coordinating Agency(ies) for course:

Service / Course Name [Format: City Course Name]:

Service / Course Description [Name, Weeks, Hours/week]:

Probationary Weeks:

Max WSB Hours:

Maximum Weeks:

Hours per week:

WSB Billing Method: [choose one]

1 - Weekly

2 - After Course Completion

Tuition: $

Tuition Billing Requirement: [either choose one option or a combo of #s 2 and 3]

1 - No Requirement

2 - Existing Attendance Record

3 - Probationary Period Complete