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WORKFORCE INNOVATION AND OPPORTUNITY ACT PROGRAMS PRE-APPLICATION

The information that you provide on this application is confidential and will be used by the Workforce Innovation and Opportunity Act (WIOA) programs to pre-screen for eligibility purposes.

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General Information

Name
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Gender
Martial Status
Race

Education

Education Levels (choose all that apply)
Are you currently in school?
Are you interested in furthering your financial literacy?

Employment

Please provide us with the most recent or current place of employment.
Are you currently employed?
Employer Name
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Is this job secure?

Other Income

Please check all sources of income and financial assistance (applied for or receiving). Information will be verified.
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2

Family Income

Please list the name of all family members presently living in the home. If you need to add a family member, press the + icon on the right hand side of the last box.
family member info
First Name
Last Name
Relationship
Employed in the last 6 months?
If so, estimated total amount earned?
 

Other Information

Please check all that describes your situation.
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I hereby certify that all of the information is correct to the best of my knowledge.
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HOW CAN WE HELP YOU?

At Virginia Career Works, we’re dedicated to supporting you, whether you’re seeking resources for your business or looking to advance your career. Contact us today—we’re here to help!

804-333-4048

Contact Us!

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Contact

487 Main Street
P.O. Box 1117
Warsaw, VA 22572

Phone: 804-333-4048

Fax: 804-333-6378

For further ways to get in touch, visit the Contact Us page!

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© 2026 Bay Consortium Workforce Development Board | All Rights Reserved

A Babel notice is a short notice included in a document or electronic medium (e.g., website, “app,” email) in multiple languages informing the reader that the communication contains vital information and explaining how to access language services to have the contents of the communication provided in other languages.

IMPORTANT! This document contains important information about your rights, responsibilities and/or benefits. It is critical that you understand the information in this document, and we will provide the information in your preferred language at no cost to you. Call (804) 333-4048 for assistance in the translation and understanding of the information in this document.

This webpage described are 100% supported by a federal U. S. Department of Labor Employment and Training Administration Workforce Innovation and Opportunity Act (WIOA) award of $25,000.00 (#AA-30941-17-55-A-51) made to Richmond County on behalf of the Bay Consortium Workforce Development Area #13 by the pass-through entity, the Virginia Community College System. No costs of this program are financed by nongovernmental sources.

The Virginia Career Works Bay Consortium Region is an Equal Opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. For TDD Callers: Virginia Relay, call 711 or 800-828-1120. For TTY Callers: Virginia Relay, call 711 or 800-828-1140.

Steven Golas, BCWDB EO Officer is located at 487 Main Street, Warsaw, VA 22572. He can be contacted by phone at 804-333-4048 Extension 3 or sgolas@baywib.org.

The Bay Consortium Workforce Development Board website is 100 percent funded by the U.S. Department of Labor through awards totaling $1,289,877.00.

The Bay Consortium Workforce Development Board provides content in several formats that require plug-ins, or separate browser components, to properly view. All required plug-ins are free to use. If your browser or assistive technology can not view the content using the plug-in, please contact our office at 804-333-4048 for an alternate version of the content. The Plug-Ins used are: Adobe Reader and Microsoft Word Reader. You can also download and install Apache OpenOffice. Compatible with other major office suites, Apache OpenOffice is free to download, use, and distribute.

EO AND NON-DISCRIMINATION POLICY

© 2026 Bay Consortium Workforce Development Board | All Rights Reserved