Title I Workforce to Title II Adult Education Referral – TCSG

Title I Workforce to Title II Adult Education – Completed by Title I Workforce Staff

Local Adult Education Area(Required)

Participant Name(Required)

First Last

Participant Phone Number(Required)

Participant Email(Required)

Referring Provider(Required)

Referring Provider Email(Required)

Participant Vocational Goal(Required)

Reason for the Referral(Required)

Participant needs Adult Education High School Equivalency HSE services: Participant does not have high school diploma or its equivalent – not currently enrolled K-12 system

Participant needs Adult Ed training services

Adult Education Training Services

Integrated Education and Training (IETs)
English as a Second Language Classes
Citizenship Classes
Adult Literacy Classes

Note: All individuals referred to Title II Adult Education program must be basic skills deficient (e.g., performing at or below 8.9 grade level, English Language Learner, or needing high school equivalency preparation services).

Title I Workforce Staff Signature(Required)

Date

Phone

This field is for validation purposes and should be left unchanged.