About
Contact Us
Quick Links
Unemployment
New Daily Job Postings
E-Alerts
KANSASWORKS
Imagine Academy
Career Pathways
Staff Directory
Address the Board
Community Outreach
Job Fairs
Featured Jobs
News
RFPs
Schedule an Appointment
Home
Job Seekers
Recently Unemployed
Search for a Job on KANSASWORKS
Daily Job Postings
Job Fairs
Featured Jobs
Careers at Workforce Alliance
Skills Assessments & Testing
Tips & Templates
Share Your Success!
Programs
Services
Registered Apprenticeship Program (RA)
Veteran Services
Labor Market Information
Employers
Find Your Rep
Request for Employer Services
Post Job Openings
Incentives and Training for Employers
Recruitment
Programs
Services
Registered Apprenticeship Program (RA)
Employer Spotlight
Gravity Works
GraceMed Health Clinic Inc
Workshops & Assessments
Kansas WORKReady! Assessments
Workshop Calendars
Spirit AeroSystems Kansas WORKReady! Assessments
Workshops
Locations
Virtual Career Center
Recently Unemployed
Seeking Employment
Career Training
Employer Resources
Toggle navigation
Home
Job Seekers
Employers
Workshops & Assessments
Locations
Virtual Career Center
Recently Unemployed
Seeking Employment
Career Training
Employer Resources
�
Partner Referral Form
Toggle navigation
Home
/
Partner Referral Form
Partner Referral Form
Referring Agency
Referring Staff Name
Referring Staff Phone
Referring Staff E-mail
Customer Name
*
Date of Birth
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
<<
<
March 2021
>
<<
March 2021
S
M
T
W
T
F
S
10
28
1
2
3
4
5
6
11
7
8
9
10
11
12
13
12
14
15
16
17
18
19
20
13
21
22
23
24
25
26
27
14
28
29
30
31
1
2
3
15
4
5
6
7
8
9
10
Last Four of SSN
Best time to contact
*
Phone
*
E-mail
*
Preferred Method of Contact
*
Select the method you'd prefer to be contacted by
Email
Phone
Participant ID (Workforce Center use only)
Check all that apply - Referral is:
*
Receiving SNAP
Employed
Receiving TANF
Unemployed
A veteran
Laid off
Eligible Spouse
Receiving Unemployment Benefits
Previous or Current Employer
*
Last Date of Employment
RadDatePicker
RadDatePicker
Open the calendar popup.
Calendar
Title and navigation
Title and navigation
<<
<
March 2021
>
<<
March 2021
S
M
T
W
T
F
S
10
28
1
2
3
4
5
6
11
7
8
9
10
11
12
13
12
14
15
16
17
18
19
20
13
21
22
23
24
25
26
27
14
28
29
30
31
1
2
3
15
4
5
6
7
8
9
10
Requesting training assistance:
Yes
No
School Preference and Program
If referral is ages 16-24, check each applicable box
Homeless
English Language Learner
Runaway
Pregnant or Parenting
Disabled
Currently or previously in foster care
Program
Not Sure
Job Corp
American Indian Council
Career Center - General Inquiry for Job Seekers
Jobs for Veterans State Grant
KHPOP - Kansas Healthcare Professional Opportunity Project
Adult, Dislocated Worker
TAA - Trade Adjustment Assistance
SCSEP - Senior Community Service Employment Program
WIOA Youth Program
YEP - Youth Employment Project
PCA - Patient Care Assistance
Customer Referred To
Reason for Referral/Additional Comments
Attachment 1
Attachment 2
Attachment 3
Attachment 4
Attachment 5
Attachment 6
UserEmailAddress
*
Type the code from the image
Please wait while we are processing ...
News
Workforce Centers to Reopen to the Public March 8, 2021
Wichita Workforce Center Assisting With WERAP
Workforce Alliance Receives $9.9 Million Grant for Training in Technology and Advanced Manufacturing Careers