Are you a not-for-profit, municipality or public benefit corporation?

Have you read through the eligibility requirements for the Employee Training Incentive Program which can be found here

Has the training program or internship program already begun?

Will the skills training program or internship program take place in New York State?

A training curriculum describing the skills and knowledge to be gained by the individuals completing the program, the activities to be engaged in, and the duration of the training/internship program MUST be provided as part of your application. Are you providing or will you provide a written curriculum for the skills training program or internship program?

Project Street Address: Please input the project street address (Street Number and Street Name only).

If the project has multiple locations, please input the primary street address of the project. If the project does not have a definite street address, please input the approximate street address of the project (Street Number and Street Name only).

Project City

Project State

Project county or counties.

Project ZIP Code. (please use ZIP+4 if known)

US Congressional District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)

For more than one project location, please provide full address(es) for each location. If Not Applicable, indicate "NA".

Project Latitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)

Project Longitude (This question's value will be filled automatically, based on the project address, when the application is finalized.)

NYS Assembly District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)

NY Senate District where the project is located. (This question's value will be filled automatically, based on the project address, when the application is finalized.)

Type of Applicant (select all that apply)

Is the applicant a DBA?

What is the applicant's DBA name?

Select an applicant ID type from the list below that you normally use to identify your organization on application forms.

Based on your selection from the previous question, enter the assocaited ID number.

If you are a business, have you been certified as a New York State Minority or Women-owned Business Enterprise (MWBE)?

Organization Legal Name

Applicant First Name

Applicant Last Name

Applicant Street Address

Applicant City

Applicant State

Applicant ZIP Code. (please use ZIP+4 if known)

Applicant Telephone Number (please include area code)

Applicant Email Address

Please select the primary sector or characterization that best defines this project.

Please select the secondary sector or characterization that best defines this project.

Project Description. Concisely describe the project, indicating the location, what will be planned, designed, acquired, and/or constructed, the issues/opportunities to be addressed, and expected outcomes and deliverables. Additional details will be collected later in the application process.

Does your project advance downtown revitalization and strategic community investment?

If Yes, please detail how it will advance downtown revitalization and strategic community investment.

Does your project improve access to child care?

If Yes, please detail how it will improve access to child care.

Does your project incorporate environmental justice practices?

If Yes, please detail how it will incorporate environmental justice practices.

Does your project directly address the needs of people in your region who are living in poverty and who seek resources for inclusion in the economic life of New York State?

How does your project seek to apply CFA funds for the purpose of eliminating barriers to skilled employment by poor people in your region, as identified by the Opportunity Agenda? Please describe any efforts to collaborate at the local or regional level (i.e. public, private, labor, philanthropic sectors).

Does your project provide opportunities for Veterans’ to participate in the workforce, or improve services to the Veterans’ and military families in New York?

If Yes, please explain how your project impacts the Veterans’ and military families in New York.

Does this project require State and/or Federal Environmental Review?

Please indicate the lead agency (if applicable).

Provide a brief summary of the need for the project in the geographic area proposed, the project's financing needs, including funding gaps and, where applicable, describe the additional short and long term jobs that will be created through the development of the proposed project.

Please identify the ways in which this project will advance the Regional Council's strategic plan for workforce. Please provide specific details, including how this project will address the workforce problems and opportunities faced in the region.

Explain your strategy for proceeding if the full amount of requested funding, required matching funds, and temporary financing are not secured as expected, or committed sources become unavailable.

If funding was awarded in prior WDI rounds, what were the CFA numbers for which funding was awarded? (separate multiple CFA numbers with commas)

Please provide any letters of support for the project.

Are you applying for the skills training component of the Employee Training Incentive Program?

Please attach the skills training program curriculum. The curriculum must include the following information: A summary of the course, including the duration and a timeline for the implementation, and a description of the skills to be acquired by the participants. It should also identify employees of 3rd party providers, or employees of the applicant who will be responsible for managing and training employees, and indicate the number of years the training provider has offered similar occupational skills training and/or service.

Attach an estimate of the training costs based on the amount of anticipated incremental training costs necessary to conduct the training. If the training will be conducted by a third-party training provider, you must attach three bids from potential training providers. If you do not have three bids, explain why.

Are you applying for the internship component of the Employee Skills Training Program?

Please attach the training curriculum for the Internship program. The curriculum must include the following information: A summary of the course, including the duration and a timeline for the implementation, and a description of the skills to be acquired by the participants. It should also identify employees who will be responsible for managing and training interns and their qualifications.

Attach an estimate of the total stipends to be paid to the interns participating in the internship program.

Attach an organizational chart and/or description of ownership structure including the percentage of ownership for each individual entity.

Please provide a detailed description of the project. Include details like the sector and industry the project will impact; workforce populations being targeted; method of delivering services; and curriculum needed.

Please describe the readiness of the project with a specific timeline, outlining the milestones from the project start to its completion.

Please identify the project partners and/or regional partners, including the project leader and others involved in the implementation of the project. Please be specific about the role of each partner and whether participation is assured.

Have you ever formally presented this project or components of this project to the Regional Economic Development Council? Please provide details, including round number and funding amount, if applicable.

How many individuals do you intend to train through your proposal?

Has your organization or any proposal partners engaged in workforce development programs in the past? If so, what have been your successes?

How many individuals will you seek to place into jobs following completion of the workforce development program?

Please enter the amount of private funding that will be provided for this project.

Please enter the number of net new permanent private sector jobs that will be created.

Provide performance targets and related information that describes how the project's performance will be measured.

What will be the final outcome if this project is successful?

Is a third party being used to complete this application such as consultant, accountant or attorney?

If you are a third party completing this application you must disclose your name, company and contact information.

Indicate the Primary North American Industrial Classification System (NAICS) Code associated with the activity of the business at the project location.

Describe the ownership of the applicant’s business including, if applicable, the names of principal owners:

Identify the applicant’s parent and subsidiary companies (if none, please respond with N/A):

What is the first project year? (the year in which the training program, capital investment or internship program begins)

What is the approximate end date of the training or internship program?

Does the applicant business plan to maintain their current employment level over the next 1 - 5 years?

Are you applying for the skills training component of the Employee Training Incentive Program?

Please explain how the applicant meets one or more of the criteria for being considered a strategic industry. Strategic industries are defined in the Program regulations. Click on scoring tips to view the definitions before answering this question.

Skills training component applications are only eligible if the training is related to a significant capital investment being made by the applicant business. Please provide the following information about the capital investment: 1) Provide a full description of the type of capital investment(s) being made; 2) indicate the dollar amount being invested; 3) explain how the capital investment is related to the skills training program for which you are seeking assistance.

Capital investment is defined in the Program regulations. Click on scoring tips to view the definition before answering this question.

Estimate the total eligible training costs associated with the skills training program. Eligible costs are incremental costs relating to the training (i.e. supplies, materials, equipment), or incidental costs necessary to conduct the training (i.e. travel, lodging, meeting space) OR fees charged by a third party training provider.

Where will the employee skills training take place?

Are you applying for the internship component of the Employee Skills Training Program?

Please identify the advanced technology, life sciences, software development or clean energy field in which the internship training will take place. Click on "scoring tips" to view definitions for each field.

Does the internship program exist solely within New York State and provide training to current students, recent graduates and/or recent members of the armed forces?

Does the business applying for internship program tax credits employ less than 100 people in New York State?

Who will conduct the internship program training?

Will the internship program last longer than twelve months per intern or displace current employees of the business?

Will the internship training be provided to interns who have not previously participated in an eligible internship program?

Will the internship training be provided to interns who are not current or former employees of the applicant business?

Will the interns participating in the internship program comprise less than 50% of the workforce of the applicant business?

How many interns will be included in the eligible internship program?

Pursuant to section 443(2) of the New York State Economic Development Law: As the preparer of this application, I attest to being an authorized representative of the applicant and, by placing my name in the box below, I hereby: 1. Agree to allow the Department of Taxation and Finance to share tax information with the Department of Economic Development. However, any information shared as a result of this agreement shall not be available for disclosure or inspection under the State Freedom of Information law; 2. Agree to allow the Department of Labor to share tax and employer information with the Department of Economic Development. However, any information shared as a result of this agreement shall not be available for disclosure or inspection under the State Freedom of Information Law; 3. Allow the Department and its agents access to any and all books and records the Department of Economic Development may require to monitor compliance; 4. Provide a clear and detailed presentation of all related persons as defined in subparagraph (c) of paragraph 3 of subsection (b) of section 465 of the Internal Revenue Code to the applicant to assure the Department of Economic Development that any jobs indicated in this application are not being shifted within the State; 5. Certify, under penalty of perjury, that no employees of the applicant shall be displaced as a result of the provision of an internship program pursuant to section 442(2) of the Economic Development Law; 6.Certify, under penalty of perjury, that the applicant is in substantial compliance with all environmental, worker protection, and local, state and federal tax laws.

By entering your name in the box below, you certify that you are authorized on behalf of the applicant and its governing body to submit this application. You further certify that all of the information contained in this Application and in all statements, data and supporting documents which have been made or furnished for the purpose of receiving assistance for the project described in this application, are true, correct and complete to the best of your knowledge and belief. You acknowledge that offering a written instrument knowing that the written instrument contains a false statement or false information, with the intent to defraud the State or any political subdivision, public authority or public benefit corporation of the State, with the knowledge or belief that it will be filed with or recorded by the State or any political subdivision, public authority or public benefit corporation of the State, constitutes a crime under New York State Law.