Assessment Notice

When Used: Used when scheduling an appointment in an office location different than the location associated to your Worker ID

Work Programs Special Instruction: Used when scheduling an appointment in an office location different then the location associated to your Worker ID. Use the V808.

Assessment Date: *MM/DD/YYYY*

Assessment Time: *HH:MM*

Assessment Location: *OFFICE NAME AND ADDRESS* *OFFICE CITY* *OFFICE STATE* *OFFICE ZIP*

Type of Assessment: *ASSESSMENT NAME*

Contact Person: *Worker Name* & Phone: *Phone number*

Assessments will help us decide which activities or programs you are a good match for.  To be eligible for cash benefits, you must attend your appointments and complete your assessments.

You must call your worker prior to your appointment if you cannot attend or need to reschedule. If you miss your appointment you must call within 24 hours after the appointment date and time to report good cause. You may be asked to provide documentation for your absence. Failure to call your worker and not attend an appointment will result in an immediate penalty. You will not be given any further notice for good cause.

Please plan for transportation and child care in advance of the appointment. Let your worker know if you need these services. Do not bring children to this appointment.

Penalties: Failure to meet work program requirements will result in your entire family losing their cash benefit. The first penalty will result in losing your cash for a minimum of 3 months. The second penalty will result in losing your cash for a minimum of 6 months. The third penalty will result in losing your cash for a minimum of 1 year. If you get more than 3 penalties, your family will lose cash benefits for a minimum of 10 years. If you receive food assistance, the person who is penalized will be removed from the food assistance benefits during the penalty period.

You will have to participate in a work program activity and reapply for cash once the minimum penalty period is over. This is in accordance with Kansas Economic and Employment Services Manual.

FAET

When Used: When scheduling an appointment in an office location different then the location associated to your Worker ID

Special Instruction: Use the V808.

Assessment Date: *MM/DD/YYYY*

Assessment Time: *HH:MM*

Assessment Location: *OFFICE NAME AND LOCATION*

Type of Assessment: *ASSESSMENT NAME*

Contact Person: *NAME* & Phone: *PHONE NUMBER* 

Assessments will help us decide which activities or programs you are a good match for. 

Please call your Employment and Training (E&T) Career Navigator prior to your appointment if you cannot attend or need to reschedule.

Please plan for transportation and child care in advance of the appointment. Let your worker know if you need these services. Do not bring children to this appointment.

 

NOTE: <If adding notes, the maximum number of lines available are 6>

Spanish Translation:

Fecha de la evaluación: *MM/DD/AAAA*

Horario de la evaluación: *HH:MM*

Lugar de la evaluación: *NOMBRE Y UBICACIÓN DE LA OFICINA*

Tipo de evaluación: *NOMBRE DE EVALUACIÓN*

Persona de contacto: *NOMBRE* y Teléfono: *NÚMERO DE TELÉFONO*

Las evaluaciones nos ayudarán a decidir cuáles actividades o programas se adaptan mejor para usted.

Comuníquese con su navegador de carreras de Empleo y Capacitación (E&T) antes de su cita si no puede asistir o necesita reprogramarla.

Planifique el traslado y el cuidado infantil antes de la cita. Infórmele a su trabajador si necesita estos servicios. No lleve niños a esta cita.

OBSERVACIÓN: <Si se agregan observaciones, la cantidad de renglones máxima disponible es 6>