ABOUT US:

• Application Form
• Programs and Courses Form (complete one for each program/course requesting approval)
• Building Facility Accessibility Checklist
• Certifications
• Targeted Occupation List (TOL) for LWDB 14
  
• WIOA Eligible Training Provider List Policy
  
• 2023 – 2024 Approved Eligible Training Provider List 
  

• Initial Application – Attachment A
• Program Cost & Performance Data (for each program/location requesting approval) – Attachment A
• Building Facility Accessibility Checklist – Attachment B
• Certification Form – Attachment C
• A copy of current State license/ CIE license – Attachment D
• A copy of the Florida DOE approved curriculum – Attachment E
• A copy of the most recent FETPIP Report – Attachment F
• Current catalog and schedule or website link where information can be found – Attachment G
• A copy of current liability Insurance – Attachment H
• A completed W-9 Form – Attachment I
• A copy of latest audited Financial Statements/Report – Attachment J
• Please submit the application and attachments either by mail or email to:

13805 58th St. North, Suite 2-140
Clearwater, FL 33760
mmoeller@careersourcepinellas.com

Questions or comments regarding this application may be directed to Michelle Moeller at 727-608-2356 or mmoeller@careersourcepinellas.com.

All applications will be competitively reviewed and rated by CareerSource Pinellas staff with recommendations presented at regularly scheduled committee meetings. Applications receiving a favorable recommendation will go before the full Board of Directors for final approval. CareerSource Pinellas will notify approved training institutions in writing of their approval or denial for inclusion on our location approved training vendor list. Approval and subsequent addition to our list does not in any way guarantee the use or endorsement of programs. Referrals will be based upon the decision of staff, after reviewing an assessment of the client’s aptitudes, abilities, geographic location, interests, costs, and other relevant information.