Contact
CareerForce Burnsville952-703-3100careerforce.burnsville@state.mn.us
CareerForce West St. Paul651-554-5955careerforce.westsaintpaul@state.mn.us
CareerForce Shakopee952-496-8310careerforce.shakopee@state.mn.us
The following forms and guides are for contracted vendors with the county:
DHS 2114 Request for Medical Opinion (Unable to Work)DHS 2883 Request for Verification of School Attendance-ProgramDHS 3165 Status Update FormDHS 3175 Notice of Intent to SanctionDHS 3482 MFIP Self ScreenDHS 3482A MFIP Self-Screen Scoring FormDHS 3504 Brief Screening Tool for Special Learning NeedsDHS 4316 Assessor Treatment Provider ReportDHS 5784 MFIP Job Log InstructionsDHS 5784 MFIP-DWP Employment Services Weekly Job Search Activity LogDHS 5837 Work Benefit Program InformationDHS 6075 Family Stabilization Services Pre-Sanction Checklist
EDAK 0058A ESW Termination-Leave VerificationEDAK 0058ESW Employment VerificationEDAK 3017ESW Request for TrainingEDAK 3393ESW MFIP Training RequestEDAK 3503ESW Family Violence Waiver NoticeEDAK 3518ESW Medical Exam Request for Disabled MFIP HH MemberEDAK 3562ESW 30 Percent Case Sanction ReviewEDAK 3563ESW 30 Percent Sanction File Review ChecklistEDAK 3564ESW Sanction LetterEDAK 3569ESW MFIP AssessmentEDAK 3588ESW 100 Percent Sanction Case ReviewEDAK 3668ESW Interpreter Request from WFS EmployeesEDAK 3689ESW Child Care Application ProcessEDAK 3698ESW Goodwill Easter Seals MN ARMHS Program Referral FormEDAK 3699ESW GES Referral FormEDAK 3726ESW MFIP-DWP Family Stabilization Services Sanction Checklist
EDAK 0051 Training Pre-Authorization RequestEDAK 0766E Financial AuthorizationEDAK 3128 Managed Care Call for Help ListEDAK 3503 MFIP Alternative EmploymentEDAK 3562 30 Percent Case Sanction ReviewEDAK 3563 30 Percent Sanction File Review ChecklistEDAK 3588 100 Percent Sanction Case ReviewEDAK 3769 MFIP Post-Secondary Training PacketEDAK 3772 ESL-ABE School Attendance VerificationEDAK 3773 Request for MFIP Training Denial FormEDAK 3774 MFIP School ApprovalEDAK 3775 Training Probation FormEDAK 3781 MFIP Employability Measures Worksheet
Last updated: 1/27/2025 2:28 PM