Information for Approved Training Application

You have indicated that you are a student. The Approved Training Application requests approval to receive Unemployment Insurance benefits while you are enrolled in a vocational training program or post-secondary education.

If your application is approved and you qualify for unemployment benefits, your benefits will continue while you attend training even though full-time students cannot normally receive benefits. The requirements that you apply for and accept work will be waived during this time. No tuition or school expenses will be paid under this program.

To be approved, the training program must give you skills that prepare you for jobs in high demand in your area, and must be provided by a recognized training facility.

Complete all the information on the application, print it, sign it, and mail it to:

Nebraska Department of Labor
Attn: UI Benefits Section - Approved Training
P.O. Box 94600
Lincoln, NE 68509-4600

Processing will be delayed if you do not provide complete information.

If you have additional questions, please call (402) 471-9000 and ask for the Approved Training Program.

NEBRASKA DEPARTMENT OF LABOR: UNEMPLOYMENT INSURANCE Approved Training (AT) Application
SSN:	BYE: (office use only) ________________________

Last Name:	First Name:	Middle Initial:
Phone Number:	Email Address:

Name of School or Facility:
School Address:
School City:	School State:	School Zip Code:
Planned attendance dates for the ENTIRE program:	Start Date: //	End Date: //
Title of training course (e.g. accounting, nursing, CDL, welding):
The program will be completed (check all that apply): In the Classroom Online Correspondence On the Job Training
Full-Time Part-Time If part-time, why are you not attending as a full-time student?		Number of Credit Hours:
Upon completion of the program, you will receive: Certificate Diploma License Associate of Arts Associate of Science Associate of Applied Science Bachelor Masters PhD
Once you have completed your training program/degree, what occupation do you plan to pursue?
Have you applied for, or do you expect to receive assistance payments from any of the following while you attend training? (Check all that apply) The Trade Act The Workforce Investment Act (if yes, attached signed WIA letter) Vocational Rehabilitation - Payments will be made directly to: Student School Veteran's Benefits (e.g. G.I. Bill) - Payments will be made directly to: Student School Other (please explain source, amount and purpose of payments): If Other:
Are there reasons, medical or other that prevents you from doing the kind of work you have done or been training for? No Yes If yes, please explain on a separate sheet and attach it to this form.
Attach a Resume that provides the following information: Work History: Employment dates, job title, job duties, rate of pay and reason for leaving (last 5 years or last 5 jobs) Previous training/education: Courses, dates, type of certification/degree (if any) for any training/education since high school

AUTHORIZATION FOR SCHOOL/FACILITY TO RELEASE STUDENT INFORMATION I certify that the information I have provided is true and complete to the best of my knowledge. I hereby authorize the training school/facility named above to release any and all information concerning my training to the Nebraska Department of Labor. This release is valid for two (2) years from the last date I attend this training.
Signature: ____________________________________________________	Date: ___________________