Indiana Workforce Pell Application

Indiana Workforce Pell Application
About this Application

Institutions applying for Indiana Workforce Pell program approval must complete this application. All applicants should review the Indiana Workforce Pell policy, program approval flowchart, and the job aid found at [website] prior to initiating the application process. The Indiana Workforce Pell Committee reserves the right to request additional information, if needed.

Institution Submitter Information
Name

First NameLast Name
Title
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Institution Information
Institution Name
Is your institution eligible to disburse federal student aid funds pursuant to Title IV of the Higher Education Act? Institutions not approved to disburse federal student aid funds pursuant to Title IV of the Higher Education Act are not eligible to offer Workforce Pell programs.
Enter the institution's Six-Digit Title IV Office of Postsecondary Education Identifier (OPEID) Number.
Provide the date on which your Title IV Program Participation Agreement (PPA) with the U.S. Department of Education will expire. Submitters should work with their institution's financial aid officer to obtain the PPA expiration date for the OPEID number listed above.

MonthDayYear
Date
Provide the Institution or Campus Indiana Operating Address tied to the Title IV OPEID Number listed above.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
During the 5 years preceding this application submission has your institution been subject to any suspension, emergency action or termination of programs under Title IV of the Higher Education Act by the federal government? Submitters should work with their institution's financial aid officer to answer this question.

Program Information
Program Name. The program name will be used on all official certification documents and in public listings of approved programs, if approved.
Program URL. Provide the public URL that should be used in public listing of approved programs, if approved.
Program Credential Type. Indicate if the program leads to a certificate, industry-certification, licensure, degree, or completion of a registered apprenticeship program. Select all that apply.
Industry Certification Status. If the program leads to an industry certification and the student must take and pass the exam as as part of the program, it is Direct. If the program leads to an industry certification but the student is not required take and pass the exam as as part of the program, it is indirect. If the program does not lead to any industry certification, select 'Not Applicable'.
Name of Industry Certification. Denote the name of the industry certification a student earns or is eligible to earn upon completion of the program. If the program does not lead to an industry certification, SKIP this question.
Name of Licensure. Denote the name of the occupation licensure a student earns or is eligible to earn upon completion of the program. If the program does not lead to occupational licensure, SKIP this question.
Name of Registered Apprenticeship Program. Denote the name of the registered apprenticeship a student earns or is eligible to earn upon completion of the program. If the program does not lead to a registered apprenticeship program, SKIP this question.
Indiana Eligible Training Provider (ETP) Status
Program's Six-Digit Classification of Instructional Program (CIP) Code (use format XX.XXXX). This code will be used on all official certification documents and in public listings of approved programs, if approved. If unknown, the institution submitter should work with their Registrar or Provost to determine the program's CIP code at their institution.

Is the Program offered in Clock Hours or Credit Hours?
Program's total Clock Hours or Credit Hours required for completion. .
All Workforce Pell programs must be between 150 and 599 clock hours or between 4 and 15 credit hours
Program's Length in Weeks of Instruction.
All Workforce Pell Eligible Programs must be between 8 and 14 weeks of instructional time, though instructional weeks are not required to be consecutive
Eligible Workforce Pell Programs must have been offered for at least 12 months prior to submitting the application in its existing format. Existing format relates to weeks of instruction and credit/clock hour requirements. If the program has changed modality (online, in-person, hybrid), the submitter should choose the option that reflects this. Programs unable to attest to this requirement are ineligible to be considered for approval.

Please upload evidence that the program has operated, in its current form per this application, for at least one year from today’s date. Evidence may include copies of a course catalog from at least 12 months ago, program syllabus, etc. Do not upload documents containing personally identifiable information (PII) or other sensitive data.

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Please indicate the date the program begin operating based on the evidence provided in the previous question.

MonthDayYear
Date
What percent of this program is provided by an ineligible third-party provider?
Provide the program's tuition and fees for the most recent academic year
Upload documents describing the program’s structure, including individual courses, instruction schedule and modality. Do not upload documents containing personally identifiable information (PII) or other sensitive data.

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Is this program offered as a correspondence course? A correspondence course is defined as a home-study program where an institution provides instructional materials and examinations to students who are separated from the instructor and the instructor does not provide regular and substantive interaction. Correspondence programs are not eligible for Workforce Pell.
Is this program offered as part of a study abroad program? A study abroad program is defined as an educational program in a foreign country where a student remains enrolled at their home U.S. institution. Study Abroad programs are not eligible for Workforce Pell.
Is this program offered as a direct assessment program? A direct assessment program measures student learning by evaluating demonstrated knowledge and skills or competencies rather than clock hours or credit hours. Direct Assessment programs are not eligible for Workforce Pell.

Can your institution demonstrate this program – collectively or individually – is included within the institutions’ grant of accreditation? Submitters should work with their institution's Accreditation Liaison Officer to answer this question. Workforce Pell programs must fall within the scope of the institution's grant of accreditation. Selecting 'Unsure' may result in application processing delays.
How will this program articulate to academic credit (select all that apply)?
Optional: provide additional information about how this program articulates to academic credit. To upload documents, use question below.
Optional: upload additional information about how this program articulates to academic credit.

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Can the program submitted cohorts be validated for completion and employment within the current DWD data systems (ETPL WRG). If 'No' is selected, instructions for a secure transfer file will be coordinated with applicant.

Program Workforce Alignment
Provide the Six-Digit Standard Occupational Classification (SOC) Code for which the program prepares individuals for employment (use format XX-XXXX). This code will be used on all official certification documents and in public listing of approved programs, if approved. (If the program leads to multiple SOC codes, list each SOC code separated by a comma.)
The program must lead to at least one high-wage, high-demand occupation as defined by the state of Indiana. More information about Indiana's high-wage, high-demand occupations can be found at [website].
OPTIONAL: Upload documentation that clearly demonstrates employer validation of program competencies and hiring needs. Per the Workforce Pell Certification Policy, documentation may include, but is not limited to: a completed Indiana Workforce Training Employer Feedback Form (available here), job postings, employer letters of support, workforce board letters of support, and/or minutes from workforce board/occupational advisory meetings. Do not upload documents containing personally identifiable information (PII) or other sensitive data.

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Optional: provide any other information the Workforce Pell Committee should consider as part of this program's application for review.

Application Submission
By submitting this form, I acknowledge that the information I've given in this form is accurate and I agree all the terms and conditions.

Eligibility Determination - Please Submit!

Thank you for your interest in the Indiana Workforce Pell Program Application. Based on the response(s) provided on this form, your institution and/or this program is ineligible to be considered for Workforce Pell consideration at this time. PLEASE CLICK 'SUBMIT' to inform the Workforce Pell Committee of this application for additional review and final determination, including information about the state's Workforce Pell Program Decision appeal process.
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Indiana Workforce Pell Application

About this Application

Institution Submitter Information

Institution Information

Program Information

Program Workforce Alignment

Application Submission

Eligibility Determination - Please Submit!