333 E. Washington Street, Stockton, CA 95202 (209) 468-1000
By submitting this form I certify that,
I understand that the purpose of Welfare-to-Work is to help me prepare for work and find a job.
I have watched the Welfare-to-Work Orientation video and understand my Rights and Responsibilities.
I viewed and/or downloaded or requested a copy of the Welfare-to-Work Handbook.
I know that I have certain rights and responsibilities as a participant in Welfare-to-Work.
I know that I must meet all my responsibilities as a Welfare-to-Work participant.
If I fail to meet my responsibilities without good reason, I know that there are certain penalties and that my cash aid may be affected.
* By checking this box, you agree to the use of electronic signatures. This will have the same legal effect as delivery of an original executed copy of this form for all purposes.