TradeOn-The-Job Training (OJT)Monitoring

Instructions

This form is to be completed by the LWIA Monitor on a monthly basis.

Customer Information
This form is a combined form to be used for ALL Trade Programs. Check the appropriate Trade Program petition requirements that apply for this individual.
1. / LWIA#/ETC / Enter the LWIA # and ETC where the customer is being served.
2. / Customer SSN / Enter the last 4 digits of the customer’s SSN.
3. / Monitoring Date / Enter the date this form is being completed.
4. / Name
/ Enter the customer's last name, first name and middle initial.
5. / Street Address (Residence) / Enter the street address where the customer currently resides. Enter apartment number, if applicable.
6. / City / Enter the city where the customer currently resides.
7. / State / Enter the State where the customer currently resides.
8. / Zip / Enter the 5 digit zip code where the customer currently resides.
TradeOJT Employer Information
9. / Name of Company / Enter the Name of the Company who made a commitment to hire the customer under the terms of an On-The-Job Training agreement.
10. / Phone Number / Enter the phone number for the OJT Company.
11. / Contract Certifier (Name/Title) / Enter the company or employer personnel responsible for developing the OJT agreement. Record name and title.
12. / Street Address (Facility of Employment) / Enter the street address of the work site. Enter the PO Box if used as the mailing address.
13. / City / Enter the city of the work site.
14. / State / Enter the state of the work site.
15. / Zip / Enter the 5 or 9 digit zip code for the work site.
16. / Company Contact Name / Enter the name of the company contact for the OJT contract.
17. / Company Contact Title / Enter the title of the company contact for the OJT contract.
18. / Phone Number / Enter the phone number of the company contact for the OJT contract.
19. / Supervisor Name / Enter the name of the customer's OJT supervisor for this contract.
20. / Phone Number / Enter the phone number of the company supervisor for the OJT contract.
Trade OJT Monthly Training Progress Report
21. / LWIA Monitor's Name / Enter the name of the LWIAmonitor. The LWIA shall assign staff to conduct monitoring at least once a month on each customer and the tasks performed.
22. / Training Period Monitored / Enter the date indicating the period the customer's progress is being monitored.
23. / Training Progress Outline / Monitor’s verification of the progress of the learning objectives and tasks negotiated with the customer and employer is entered in this section. This tracking should be done on a monthly basis. Information is taken from Commerce/Trade Form #008 TradeOJT Planning Form Item #37.
24. / Number of Hours Completed
/ By task, enter the number of hours completed.
25. / Date Started / Enter the date the task was started.
26. / Date Completed / Enter the date the task was successfully completed. If the task has not been completed, enter the date the task is planned to be completed.
27. / Confirmation of Information/Initials / The customer's supervisor and the customermust Initial each task, indicating they are in agreement with the hours worked, date started, and date of completion or planned completion. The LWIA Monitor must witness this agreement to ensure both are aware of what is being recorded.
28. / Total Hours Completed / Enter the total number of hours completed.
LWIA Monitoring Assessment
29. / Indicate the Progress of the Customer / Attests to the satisfactory or unsatisfactory progress of the customer. Check the appropriate box. The LWIA Monitor certifies that the customer has met all attendance requirements and is making satisfactory progress or the customer has not met attendance requirements or has not made satisfactory progress. Also check yes or no if the absence was justified. Any absence must be recorded on IWDS as a Potential Suspension Request. The LWIA must also record on the Potential Suspension Request if the absence was justified or not justified and the reason why.
30. / Monitor’s Comments / Findings are entered here and a copy of this form should be provided to the customer and employer. If the careerplanner is someone other than the monitor, the careerplanner will need a copy and may want to re-negotiate the terms of the agreement.
31. / Customer Signature and Date / The customer must sign and date this form.
STAFF USE ONLY
32. / LWIA Monitor Signature and Date / The LWIAmonitormust sign and date this form.

January 20, 2016Page 1 of 2Instructions: Commerce/Trade Form #010