Special Employer Incentive Contract No

Appendix Q

SPECIAL EMPLOYER INCENTIVE CONTRACT NO:

Re: NAME ***-**-***

(TITLE 38, UNITED STATES CODE CHAPTER 31)

This contract is made as of this Number day of MonthYear, between the DEPARTMENT OF VETERANS AFFAIRS and Name of Business, (hereinafter referred to as the Employer), an institution located at Address of Business.

WITNESSETH: ______

WHEREAS, the Department of Veterans Affairs is authorized to pay for courses of vocational rehabilitation for Veterans under the provisions of 38 USC § 3104, and

WHEREAS, the Employer is approved for vocational rehabilitation of Veterans under 38 USC Chapter 31 by the Department of Veterans Affairs.

NOW, THEREFORE, in consideration of the promises and mutual convenience and agreements hereinafter contained, the parties hereto do mutually agree as follows:

ARTICLE 1. INSTRUCTION

(a)The Employer will provide on-job instruction and necessary books, supplies, and equipment therefore set forth in paragraphs (c) and (d) below. During the period beginning ______and ending ______, such Veterans described herein may be accepted or retained by the Employer as students in courses described or identified in Schedule I attached hereto.

(b)This contract shall apply to Veterans, who are approved and designated by the Department of Veterans Affairs as being entitled to vocational rehabilitation training under 38 USC Chapter 31.

(c)The Employer will provide such courses of instruction at the charges listed and described in Schedule I attached hereto, or as set forth in the catalogs, bulletins, or other publications of schedules, which are submitted herewith and identified in Schedule I as part of this contract.

(d)The Employer will furnish outright to the Veteran, as needed, such books, supplies, and equipment as are necessary for the satisfactory pursuit and completion of the courses as referred to in paragraph (c) above. It is understood and agreed that the books, supplies, and equipment furnished will consist of those forms required, but in no instance greater in variety, quality, or amount that are required by the Employer to be provided personally by other and all students pursuing the same or similar courses.

(e)The Department of Veterans Affairs will compensate the Employer for the on-job training, books, supplies, and equipment as provided in Schedule I attached hereto.

IN WITNESS THEREOF, the parties hereto have executed this contract as of the day and year first above written:

______

Name of the Company

TWO WITNESSES - EMPLOYERDEPARTMENT OF VETERANS AFFAIRS

______By: ______

NameTitle: VR&E Officer

Address Address: VA Regional Office

______

______

______By: ______

NameTitle: Case Manager

Address Address: VA Regional Office

______

______

TAX ID NUMBER:

CITY/COUNTY BUSINESS LICENSE NUMBER:

WORKERS COMPENSATION POLICY NUMBER:

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