LOCAL WORKFORCE INVESTMENT BOARDS (LWIBS)



APPENDIX A: local workforce investment boards (lwibs)

workforce investment act of 1998 (wia) 2009 re-certification

lwib NAME:      

|WIB CHAIR CONTACT INFORMATION (Name, address, telephone, fax, email): |

|      |

|      |

| |

|wib member name/title |Business name |wib composition category |term of appointment |

| |(address, telephone. fax, email) | |(date of appointment/ |

| | | |expiration of term) |

| |aDDRESS:       |bUSINESS REPRESENTATIVES | |

|      |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO |      |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

| |aDDRESS:       |bUSINESS REPRESENTATIVES | |

|      |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO |      |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

| |aDDRESS:       |bUSINESS REPRESENTATIVES | |

|      |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO |      |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

| |aDDRESS:       |bUSINESS REPRESENTATIVES | |

|      |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO |      |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

PAGE 2

|wib member name/title |Business name |wib composition category: |term of appointment |

| |(address, telephone. fax, email) | |(date of appointment/ |

| | | |expiration of term) |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

pAGE 3

|wib member name/ title |Business name |wib composition category |term of appointment |

| |(address, telephone. fax, email) | |(date of appointmenT/ |

| | | |expiration of term) |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

Page 4

|wib member name/ title |Business name |wib composition category |term of appointment |

| |(address, telephone. fax, email) | |(date of appointmenT/ |

| | | |expiration of term) |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

PAGE 5

|wib member name/ title |Business name |wib composition category |term of appointment |

| |(address, telephone. fax, email) | |(date of appointmenT/ |

| | | |expiration of term) |

|      |aDDRESS:       |bUSINESS REPRESENTATIVES |      |

| |cITY, sTATE, zIP cODE:       |Business Owner |      |

| |tELEPHONE/FAX:       |CEO/COO | |

| |EMAIL:       |other business executive or employer with optimum policy making or hiring | |

| |nUMBER OF EMPLOYEES:       |authority | |

| |INDUSTRY SECTOR:       |business with employment opportunities that reflect opportunities of the local| |

| | |area | |

|Total number business members:       |

|      |aDDRESS:       |eDUCATIONAL ENTITIES |      |

| |cITY, sTATE, zIP cODE:       |local educational entity (K-12) |      |

| |tELEPHONE/FAX:       |local school board | |

| |EMAIL:       |provider of adult education and literacy services | |

| | |post-secondary educational insitution | |

|      |aDDRESS:       |eDUCATIONAL ENTITIES |      |

| |cITY, sTATE, zIP cODE:       |local educational entity (K-12) |      |

| |tELEPHONE/FAX:       |local school board | |

| |EMAIL:       |provider of adult education and literacy services | |

| | |post-secondary educational insitution | |

|      |aDDRESS:       |eDUCATIONAL ENTITIES |      |

| |cITY, sTATE, zIP cODE:       |local educational entity (K-12) |      |

| |tELEPHONE/FAX:       |local school board | |

| |EMAIL:       |provider of adult education and literacy services | |

| | |post-secondary educational insitution | |

|      |aDDRESS:       |eDUCATIONAL ENTITIES |      |

| |cITY, sTATE, zIP cODE:       |local educational entity (K-12) |      |

| |tELEPHONE/FAX:       |local school board | |

| |EMAIL:       |provider of adult education and literacy services | |

| | |post-secondary educational insitution | |

|Total number educational entity members:       |

pAGE 6

|wib member name/tITLE |Business name |wib composition category: |term of appointment |

| |(address, telephone. fax, email) | |(date of appointmenT/ |

| | | |expiration of term) |

|      |aDDRESS:       | LABOR ORGANIZATIONS |      |

| |cITY, sTATE, zIP cODE:       |other represenative of employees |      |

| |tELEPHONE/FAX:       | | |

| |EMAIL:       | | |

|      |aDDRESS:       | LABOR ORGANIZATIONS |      |

| |cITY, sTATE, zIP cODE:       |other represenative of employees |      |

| |tELEPHONE/FAX:       | | |

| |EMAIL:       | | |

|Total number labor organiztion members:       |

|      |aDDRESS:       |Community-based organizations |      |

| |cITY, sTATE, zIP cODE:       |indiviudals with disabilities CBO |      |

| |tELEPHONE/FAX:       |veterans cbo | |

| |EMAIL:       |other:       | |

|      |aDDRESS:       |Community-based organizations |      |

| |cITY, sTATE, zIP cODE:       |indiviudals with disabilities CBO |      |

| |tELEPHONE/FAX:       |veterans cbo | |

| |EMAIL:       |other:       | |

|total number cbo members:       |

|      |aDDRESS:       |Economic development agencies |      |

| |cITY, sTATE, zIP cODE:       |public sector economic development entity |      |

| |tELEPHONE/FAX:       |private sector economic development entitty | |

| |EMAIL:       | | |

| |aDDRESS:       |Economic development agencies |      |

|      |cITY, sTATE, zIP cODE:       |public sector economic development entity |      |

| |tELEPHONE/FAX:       |private sector economic development entitty | |

| |EMAIL:       | | |

|total number economic development members:       |

PAGE 7

|wib member name/tITLE |Business name |wib composition category |term of appointment |

| |(address, telephone. fax, email) | |(date of appointmenT/ |

| | | |expiration of term) |

|      |aDDRESS:       |one-stop partners |      |

| |cITY, sTATE, zIP cODE:       |vocational rehabilition |      |

| |tELEPHONE/FAX:       |tanf | |

| |EMAIL:       |older americans | |

| | |veterans | |

| | |job corps | |

| | |apprenticeshhip | |

|      |aDDRESS:       |one-stop partners |      |

| |cITY, sTATE, zIP cODE:       |vocational rehabilition |      |

| |tELEPHONE/FAX:       |tanf | |

| |EMAIL:       |older americans | |

| | |veterans | |

| | |job corps | |

| | |apprenticeshhip | |

|Total number one-stop partner members:       |

|      |aDDRESS:       | other |      |

| |cITY, sTATE, zIP cODE:       | |      |

| |tELEPHONE/FAX:       | | |

| |EMAIL:       | | |

|      |aDDRESS:       | other |      |

| |cITY, sTATE, zIP cODE:       | |      |

| |tELEPHONE/FAX:       | | |

| |EMAIL:       | | |

|      |aDDRESS:       | other |      |

| |cITY, sTATE, zIP cODE:       | |      |

| |tELEPHONE/FAX:       | | |

| |EMAIL:       | | |

|      |aDDRESS:       | other |      |

| |cITY, sTATE, zIP cODE:       | |      |

| |tELEPHONE/FAX:       | | |

| |EMAIL:       | | |

PAGE 8

|wib member name/tITLE |Business name |wib composition category |term of appointment |

| |(address, telephone. fax, email) | |(date of appointmenT/ |

| | | |expiration of term) |

|      |aDDRESS:       | other |      |

| |cITY, sTATE, zIP cODE:       | |      |

| |tELEPHONE/FAX:       | | |

| |EMAIL:       | | |

|total number other members:       |

|total wib members:       |

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