Ohio Career Launch Application OhioMeansJobs-Meigs County · 150 Mill Street, Middleport Ohio 45760 · Phone: 740-444-7641 · Fax: 740-992-1668
Comprehensive Case Management and Employment Program
Youth & Young Adults Ages 14-24!
CCMEP takes a complete approach to stabilizing individuals and families, by addressing a variety of factors including health, addiction/substance abuse issues, housing, education, transportation, school dropout prevention, career pathways and more! CCMEP will provide access to employment and training services including career counseling, career coaching, job placement, job shadowing, and summer employment. Our goal is to improve employment and education outcomes for youth and young adults by helping them overcome barriers to employment and education, by developing the successful skills local employers and educators seek.
If you believe you fit this program and have the self-drive to want to make your goals a reality, please complete the attached application and paperwork. After we receive your application, a caseworker will contact you to set up a series of appointments to determine eligibility and complete an Assessment and Individual Opportunity Plan (IOP).
We will need the following verification to determine CCMEP eligibility:
Complete attached packet with signatures (parent/guardian if you are under 18 years of age). Voter registration is optional Proof of minor living in your household or proof of parenting. Proof of age/birthday (birth certificate) Proof of Citizenship status (Social Security Card) Proof of residence of Meigs County Proof of school status (report card, transcripts, letter from school, etc.) Proof of high school diploma or GED (if applicable) Proof of last 6 months income for all family members Ohio Career Launch Application WIOA Income Eligibility (if needed) This section determines income eligibility. If you are an in-school youth (i.e., attending high school or a post-secondary program), do not complete if you are homeless, a runaway, or a foster youth. If you are not attending school, only complete if your case manager requests you to do so.
Please answer the following questions if you are 18 or older*
Do you provide more than 50% of your own support? Yes No
Are you married or separated but not divorced? Yes No
Do you have children who receive more than half of their support from you? Yes No
Do you have dependents (other than your children or spouse) who live with you and who receive more than half of their support from you? Yes No
Do you have your own residence or in a residence without support from a parent(s) or a guardian(s)? Yes No
Have you been, or are you a member of, a family who received public cash or food assistance in the last 6 months? Yes No
*If you answered “YES” to any question directly above, you are independent of a parent or guardian and only your income will be used to determine WIOA youth eligibility.
Only complete the next section if you are attending school (high school or college/technical school) or your case manager asks you to.
Including yourself, who is in your household? What is their relationship to you? What is their average monthly income? (Your case manager can let you know the timeframe to consider.) If you have a disability, only include your personal income.
Household Members Average Monthly Income for the past ___ months
Ohio Career Launch Application Part B. TANF Funding Eligibility This section determines eligibility for TANF-funded services.
Have you or anyone you are living with been ordered to repay cash assistance (OWF), due to a determination of fraud and still owe repayment? If YES, skip to ‘Acknowledgement’ section. Yes No
Are you currently receiving cash assistance? If YES, skip to ‘Acknowledgement’ section. Yes No
Are you currently receiving SNAP? If YES, skip to ‘Acknowledgement’ section. Yes No
Complete the table below indicating each household member’s monthly income.
Household Members Monthly Income
Do you have a child under age 18 or 18 who is attending high school full-time? Yes No
Number of children Oldest child age
Are you one of the following (check all that apply): a minor child (including age 18 attending high school full-time) a parent, specified relative, legal guardian or legal custodian of a minor child a non-custodial parent
Have you been given the opportunity to register to vote? Yes No N/A (age 16 or under)
Voter registration is optional: Ohio Voter Registration form (PDF, Ohio Secretary of State) (opens in a new tab – external website)
Acknowledgement By signing, I attest that the information stated on this application is true and accurate. I understand that if the information or income provided was misrepresented, it may be grounds for immediate termination in the CCMEP program and/or penalties as specified by law. If the applicant is under age 18, the parent/guardian signature below gives permission for the youth to participate in CCMEP services and activities.
I have received a copy of the JFS Form 08063 “Complaint Rights under the Workforce Innovation and Opportunity Act (WIOA)”. Parent/Guardian Signature (If applicant is under age 18)** Write by hand after printing
Date Write by hand after printing
Applicant Signature Write by hand after printing
Date Write by hand after printing
** If a parent or guardian is not available to sign, please have the minor applicant sign and document in case notes the reason why the parent guardian did not sign.