Form 3 TAP Partner Registration Form

U.S. Department of Labor
Veterans’ Employment and Training Service
Employment Navigator (EN) Pilot
Partnership Criteria and Validation Input Form

The Department of Labor’s (DOL) Veterans’ Employment and Training Service (VETS) will be conducting an Employment
Navigator Partnership (ENP) Pilot from April 2021 through April 2022. VETS will place 54 ENs at 13 military installations
worldwide to assist targeted transitioning service members (TSMs), and their spouses (S), in identifying and selecting quality
career pathways and connecting them with quality employment and training resources and opportunities with the hopes of
improving veterans’ employment outcomes.
In support of the EN pilot, the VETS TAP Office will partner with selected high caliber employment and training organizations
from the public and private sector, to improve employment related outcomes or outputs to targeted TSMs/S at select DOD
installations. For this pilot, partnerships are defined based upon section 1144 of Title 10, U.S.C., as public and private entities. A
partnership is defined as a relationship resembling a legal partnership and usually involving close cooperation between parties
having specified and joint rights and responsibilities.
To help in our selection and eligibility process or potential partnership, DOL VETS requests completion of all following
(additional information and instructions can be found on page 3 of this document):
Partner Information:
1. Name (Enter the exact name assigned the Employer Identification Number {EIN}) ______________________________
2. Enter the Partner EIN associated with the Partner name used above (Do not enter your SSN):
____________________________
3. Enter the Data Universal Number System (DUNS) if one exists __________________________
4. Enter Partner Doing Business As (DBA) name, if utilized ____________________________________
5. Partner Street Address (Official address associated with EIN):
Number and Street ________________________________ City/Town _____________________________
State/Province _________________ Zip Code _______________ Country ___________________________
6. Point of Contact
Name: ____________________________________
Email: _____________________________________
Phone Number: _____________________________
Eligibility Criteria: To assist in identifying the potential partners that would bring high quality services to our TSMs, the
potential partner organizations must meet the following minimum requirements to be considered eligible for a partnership
for the EN Pilot (Complete all fillable areas):
1. Partner provides employment related services and support at minimal to no direct cost to Department of Labor,
the transitioning service member, or their spouse. Yes
No
a. Example of how services are at minimal to no direct cost___________________________________________
2. Partner services must have been in place for at least a year. Yes
No
3. Partner must be able to provide DOL the following:
a) Service(s) delivery method ____________________________________________________________________
b) Geographical areas of service(s):
Partner can provide service member intake from:
Local
State
Regional
National
International
Partner provides services to service members within:
Regional
National
International
Local
State
c) Industries services are provided in (NAICS sector number and industry name)
Select All
3 – Real Estate Rental and Leasing
11 – Agriculture, Forestry, Fishing and Hunting
54 – Professional, Scientific, and Technical Services
21 – Mining
55 – Management of Companies and Enterprises
22 – Utilities
56 – Administrative and Support and Waste
23 – Construction
Management and Remediation Services
31-33 – Manufacturing
61 – Educational Services
42 – Wholesale Trade
62 – Health Care and Social Assistance
44-45 – Retail Trade
71 – Arts, Entertainment, and Recreation
48-49 – Transportation and Warehousing
72 – Accommodation and Food Services
51 – Information
81 – Other Services (except Public Administration)
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52 – Finance and Insurance
92 – Public Administration

U.S. Department of Labor
Veterans’ Employment and Training Service
Employment Navigator (EN) Pilot
Partnership Criteria and Validation Input Form
d)

Willing to use DOL’s chosen platform for verified individual outcome and/or output participation data: Yes
No
Outcome
Output
Both
Verified placements (previous full CY) __________________
Total number of transitioning service members and/or their spouses that received services in previous full CY_________
Limitations on the number of transitioning service members and/or their spouses that you can serve? Yes
No
If yes, what is the anticipated yearly limitation or capacity? _________________

e)

Third party validation of outcome and/or output data. Yes
No
Third party validation entity or method: ____________________________
Responsive POCs for DOL funded staff (if different than the POC in the Partner Information section).
Point of Contact
Name: ____________________________________
Email:_____________________________________
Phone Number: _____________________________

f)

4. Must Provide at least one of the following services for transitioning service members and/or their spouses (DOL will seek
data on each item selected):
Hiring Events
Employment Networking
Employment Mentorship
Referrals to Employment Opportunities
Wrap Around Services
Digital Matching
Apprenticeship Opportunities
Training Services
Placement Services
5. Must be willing and able to execute a Memorandum of Understanding with the Department of Labor. Yes
No
Attestation Information:
First and Last Name: ____________________________________________________
Title: ________________________________________________
Contact Email: ____________________________________________
Contact Phone Number: _________________________________________
Attestation: I declare under penalty of perjury under the laws of the United States of America that:
1. I have read and reviewed this application and the information contained therein is true and accurate, and
2. I understand that to knowingly furnish false information in the preparation of this form and any supplement thereto or
to aid, abet, or counsel another to do so is a violation of Federal law under 18 U.S.C. 1001.
Entering your name above and the selection of “I agree” below constitutes your signing the attestation under penalty of perjury.
I agree

Electronic Signature: ___________________________________________

Disclaimer: Information submitted as part of this application may be made available to the public. Applicants should not include
any proprietary or confidential business information or personally identifiable information (PII) in this summary. In the event that
an applicant submits proprietary or confidential business information or PII, DOL is not liable for making this information public.
The submission of the application constitutes a waiver of the applicant's objection to the posting of any proprietary or confidential
business information contained in the application. Additionally, the applicant is responsible for obtaining all authorizations from
relevant parties for publishing all PII contained within the application. In the event the application contains proprietary or
confidential business information or PII, the applicant is presumed to have obtained all necessary authorizations to provide this
information and may be liable for any improper release of this information.

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Instructions

The following instructions are designed to assist in properly responding to the DOL VETS Employment Navigator and Partnership
Application Form. Before the form is submitted, please ensure that:
•
•
•
•

All information as submitted on the input form is correct.
Every required element of the input form has been filled out.
You have read and complied with these instructions.
Please email any additional information, documentation, or questions related to this form, to Mike Slater: [email protected]

Numbers: This section provides additional information on certain referenced numbers throughout the application form.
Partner Information:
Number 1 - Explanation provided on form.
Number 2 - The partner must enter its’ EIN unless the partner uses an agent designated pursuant to 26 CFR 31.3504-1, a payor
designated pursuant to 26 CFR 31.3504-2, or a Certified Professional Employer Organization recognized pursuant to 26 U.S.C. 7705 to
furnish the IRS Forms W-2 to its employees. If you are a partner that falls under one of these exceptions, you may leave this field blank.
Eligibility Criteria:
Number 1 - Potential partner will provide a comprehensive explanation on how their services result in minimal to no direct cost to TSMs/
S. Options could include, GI Bill, grants, scholarships, and/or funding opportunities which cover costs for supplies and/or fees.
Number 2 - DOL encourages the development and improvement of services for TSMs/S. However, to be a partner, DOL requires services
to have been active for at least a year and validated by a third party. The burden of proof is on potential partners to show that their
services are in place and are sustainable.
Numbers 3a – The type of employment related delivery method. These may consist of one-on-one in person or virtual employment
related services, digital matching services, virtual or in-person events (classroom training, fairs, cohorts, and summits, as examples).
Number 3b - The specific geographic areas of service where partner can begin services with TSMs/S and where partner can provide
services or opportunities with their employers or partners. These consist of Local (organizations that perform employment and/or training
service(s) within a specified area-whether it be city, town, county, or military installation); State (organizations that perform employment
and/or training service(s) within a specified state, or multiple counties, towns, cities, or installations within a state); Regional
(organizations that perform services in more than one state); National (organizations that perform services in two (2) or more CONUS
regions or across all CONUS states, and/or installations); and International (organizations that perform services across all CONUS states,
and/or installations, as well as at international countries or installations).
Number 3d – Partner will commit to reporting data on DOLs platform, once established. Also, Partner will identify if outcome, output, or
both data options can be tracked, current placements (if applicable), and if there are limitations to the yearly capacity Partner can serve.
Number 3e - Third party verifications can come in the form of audits, survey results from those who attended services, employer paystubs for those who were placed into employment, annual reports, or other methods that are deemed appropriate. Potential partners
will be asked to provide some documentation supporting third party verification.
Number 4 - The type of employment related service that partner organization provides to transitioning service members
TSMs/S. These include:
(1) Hiring Events: Partner offers face-to-face or digital capabilities for TSMs/S, to access employment and networking opportunities,
and on-the-spot interviews/hiring.
(2) Employment Networking: Partner provides access to networking opportunities with organizations committed to hiring and/or
providing other employment and training related services for TSMs/S.
(3) Employment Mentorship: Partner maintains a directory of mentors willing and available to provide employment and training
guidance to TSMs/S, at varying levels of career readiness.
(4) Referrals to Employment Opportunities: Partner leverages their strong relationship with local, state, regional, national, and/or
international employers to offer direct referrals to organizations committed to hiring and/or providing other employment,
education, and training related services for TSMs/S.
(5) Wrap around services: An organization that provides a combination of individualized services for TSMs/S, veterans, their families,
and/or caregivers. Services may include: Medical support, legal counsel, job search and/or placement services, housing support,
financial assistance, entrepreneurship training, apprenticeship training, and education and training assistance, etc.
(6) Digital Matching: Partner has a digital platform that matches the skills and experience of TSMs/S, with potential employment
opportunities.
(7) Apprenticeship Opportunities: Partner connects transitioning service members, their spouses, veterans, and members of the
Reserve and National Guard with registered apprenticeship, and/or industry recognized apprenticeship program opportunities
within selected industries.
(8) Training Services: Partner provides education or skill training opportunities that are recognized by industry leaders and supports
employment prospects for TSMs/S.
(9) Placement Services: Partner has means to assess skills and employment goals for TSMs/S , to identify employment placement
opportunities, and place TSMs/S into employment. Partner must have on-going relationships with local, state, regional, national,
and/or international employers that are hirin
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