Mandatory E & T Self-Sufficiency AgreementSelf-Sufficiency Agreement • June 15th, 2022
Begin Date Specific & Measurable Action Hours/Week Due Date I am responsible for attending all appointments scheduled with my Career Navigator and providers and for turning in verification I have met 120 hours of monthly participation by the 6th of the month. N/A For as long as I am participating with Employment Services. I am responsible for notifying my Career Navigator if any changes occur in my situation that may require an adjustment to this plan including but not limited to a change in employment. N/A I am responsible for I am responsible for I am responsible for
Self-Sufficiency Agreement Department of Social Services Division of Family Independence| CED B-4319 (1/2020)Self-Sufficiency Agreement • January 15th, 2020
Name: Date:Self-Sufficiency Agreement • June 15th, 2022
Begin Date Specific & Measurable Action Hours PerWeek Due Date I am responsible for attending all appointments scheduled with myCareer Navigator and with the providers I have been referred to. N/A For as long as I am participating with Employment Services. I am responsible for notifying my Career Navigator if any changes occur in my situation that may require an adjustment to this plan including but not limited to a change in employment. N/A I am responsible for I am responsible for I am responsible for
Self-Sufficiency AgreementSelf-Sufficiency Agreement • February 4th, 2020
TANF Self-Sufficiency AgreementSelf-Sufficiency Agreement • June 15th, 2022
Begin Date Specific & Measurable Action Hours PerWeek Due Date I am responsible for attending all appointments scheduled with my Career Navigator and withthe providers I have been referred to. N/A For as long as I am receiving TANF. I am responsible for pursuing medical coverage and keeping the coverage once it is approved. N/A I am responsible for notifying my Career Navigator if any changes occur in my situation thatmay require an adjustment to this plan including but not limited to a change in employment. N/A I am responsible for I am responsible for I am responsible for
E&T Self-Sufficiency AgreementSelf-Sufficiency Agreement • March 25th, 2019
