Central Connections – Rights and Consent


  • 1. Workforce Innovation and Opportunity Act (WIOA) Participant Rights

    I hereby certify that I have received, read and understand the following documents as an Applicant/Participant of the Workforce Innovation and Opportunity Act (WIOA) and/or TANF Youth Development Program and acknowledge so with my signature at the end of this form.

    Please also indicate your acknowledgement with a check next to each document received, read and understood.


  • 2. Consent to Release of Information

    As a participant in a Workforce Innovation and Opportunity Act Title I program or as a member of the participant’s family, I give permission to release any and all information pertinent to my past and present educational, employment, and training history to all partners of Central Region PA CareerLink® and all agencies subcontracted by Central Pennsylvania Workforce Development Corporation to provide Title I services. I authorize partners to exchange information concerning my situation during my enrollment and follow-up period. Partners and contractors may include, but are not limited to:

    • Advance Central PA
    • Bureau of Workforce Partnership and Operations
    • Central Susquehanna Intermediate Unit (CSIU)
    • Central Susquehanna Opportunities, Inc. (CSO)
    • County Assistance Offices
    • Current/Former Employers
    • Domestic Relations Office
    • Law Enforcement Agencies
    • Local Education Agencies
    • PA CareerLink®
    • Social Security Information
    • Tuscarora Intermediate Unit 11 (TIU)

    Authorization includes the following additional organizations or individuals (Applicant must initial any additions):


  • All information will be maintained in the strictest of confidence.


    Participant Acknowledgement and Consent
    By signing I acknowledge that I received a copy, read and understand the documents explaining WIOA Participant Rights, and I agree to and understand the Consent to Release Information.

  • Date Format: MM slash DD slash YYYY
  • Auxiliary aids and services are available upon request to individuals with disabilities.
    Equal Opportunity Employer/Programs.


  • 1. Workforce Innovation and Opportunity Act (WIOA) Participant Rights

    I hereby certify that I have received, read and understand the following documents as an Applicant/Participant of the Workforce Innovation and Opportunity Act (WIOA) and/or TANF Youth Development Program and acknowledge so with my signature at the end of this form.

    Please also indicate your acknowledgement with a check next to each document received, read and understood.


  • 2. Consent to Release of Information

    As a participant in a Workforce Innovation and Opportunity Act Title I program or as a member of the participant’s family, I give permission to release any and all information pertinent to my past and present educational, employment, and training history to all partners of Central Region PA CareerLink® and all agencies subcontracted by Central Pennsylvania Workforce Development Corporation to provide Title I services. I authorize partners to exchange information concerning my situation during my enrollment and follow-up period. Partners and contractors may include, but are not limited to:

    • Advance Central PA
    • Bureau of Workforce Partnership and Operations
    • Central Susquehanna Intermediate Unit (CSIU)
    • Central Susquehanna Opportunities, Inc. (CSO)
    • County Assistance Offices
    • Current/Former Employers
    • Domestic Relations Office
    • Law Enforcement Agencies
    • Local Education Agencies
    • PA CareerLink®
    • Social Security Information
    • Tuscarora Intermediate Unit 11 (TIU)

    Authorization includes the following additional organizations or individuals (Applicant must initial any additions):


  • All information will be maintained in the strictest of confidence.


    Participant Acknowledgement and Consent
    By signing I acknowledge that I received a copy, read and understand the documents explaining WIOA Participant Rights, and I agree to and understand the Consent to Release Information.

  • Date Format: MM slash DD slash YYYY
  • Auxiliary aids and services are available upon request to individuals with disabilities.
    Equal Opportunity Employer/Programs.