Job Network Counties


Use our form library to conveniently access important documents and applications for job assistance, employer recruitment or financial services.


Forms for Job Seekers

Resume Template - A combination-style template, highlighting skills as well as employment history.

Master Application for Employment - Use this form as a guide to assist you in filling out job applications.

Job Search Log - Do you need to keep track of the positions you are applying for?  Use this document as an aid.

Computer Skills Self-Assessment - This survey will help you identify your computer skills & assess whether additional training may be necessary.


Forms for Employers

On-the-Job Training Employer Information Form - Please complete this survey as part of your application to begin an OJT Contract.

Affidavit in Compliance with ORC - To be signed & notarized as part of the OJT application process.

W9 - Request for Employer Identification Number.


Forms for Workforce Innovation & Opportunity Act participants (Formerly WIA)

Initial Information Form - You can bring this completed form with you to complete WIOA Orientation.
* Please note this is NOT a WIOA Application. *

Verification Item Checklist - Explains which documents to bring to your scheduled WIOA appointment.

WIOA Complaint Procedure Brochure - This form explains your rights and how to file a complaint with the Delaware County WIOA program.

Employment Information - Let your Employment Counselor know you started a new job.  Please complete this form and email or fax to your assigned counselor.


Forms for Ohio Works First or Work Experience Program participants

Washington 13 Employment Needs Screening

Barriers to Employment Assessment

WEP Time Sheet - Interns, please complete this form and have your supervisor verify & sign.  Once completed, fax or scan to Renee Menssen.

Employment Verification & Release of Information - Please complete the top information regarding your employer's location and sign.  Return to Delaware County Job and Family Services.


Forms for Youth

Summer Works Time Sheet - Please fax to Youth Services Counselor at 740-833-2369.


Financial Assistance

Request for Cash, Food, and Medical Assistance - Please mail your complete, signed application to:  140 North Sandusky Street, Delaware, OH 43015

Request for Medical Assistance ONLY - Please mail your complete, signed application to:  140 North Sandusky Street, Delaware, OH 43015


Additional Forms

Veteran Questionnaire - Please complete this form & return it to OhioMeansJobs Delaware County to see if you are eligible for a referral to our Veterans' Representative.

Voter Registration - Please mail your completed form to: Delaware County Board of Elections, 2079 US 23 North, Delaware, OH 43015.

Discrimination Complaint

Discrimination Spanish



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