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Customized Training Application
Part Two

Please make sure that you have completed the Customized Training Application: Part One prior to completing Part Two.  This application should be submitted within 10 days of submitting the Customized Training Application: Part One.

Part 3:  PROPOSED TRAINING PROJECT BUDGET INFORMATION

A) Training Activities, Timeframes, and Cost: if the training project includes more than one
course/activity, please list each course/activity separately.

SubTotal Training Activities

B) Employee Eligibility and Wages: List the employees you anticipate will receive training under this grant

C) Non-Personal Training Costs (e.g. books, exam fees, uniform, supplies etc.)

D) Funds Received from Other Sources (*Attach documentation itemizing source/amount)

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PART 4: SIGNATURE OF AUTHORIZED REPRESENTATIVE

The undersigned affirm that, to the best of my/our knowledge, information, and belief, all statements in this application, including all schedules, appendices, and additional information submitted in connection herewith, are true and accurate. I/we do affirm that I/we will adhere to the non-discrimination and affirmative action policies and requirements of the State of New York.


I/we understand Workforce Innovation and Opportunity Act grant funds will be used for direct training costs only and must have a match from our Business of not less than 50% of the project cost for eligible participants.

Labor Union Information
If applicable, enter labor union information and attach their Letter of Support

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