Form Ddd-1406c - Career Preparation And Readiness

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ARIZONA DEPARTMENT OF ECONOMIC SECURITY
DDD-1406CFORFF (12-17)
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Division of Developmental Disabilities ● Employment Support and Services
CAREER PREPARATION AND READINESS
Individual Training Agreement
MEMBER NAME:
SUPPORT COORDINATOR:
Integrated Employment: Employment in a community setting where a member interacts with individuals without disabili-
ties such as Group Supported Employment.
Competitive Employment: A job in the community earning minimum wage or higher for which anyone can apply.
Describe member’s strengths towards making a progressive move into competitive and/or integrated employment:
Describe the member’s barriers keeping them form making a progressive move into competitive and/or integrated employment:
IN WHAT SPECIFIC EMPLOYMENT-RELATED ACTIVITIES WILL THE MEMBER PARTICIPATE:
Employment-Related
Member Participation
Notes
Activity
Job Readiness and
Assessment
Work Incentive Counseling
Member Representative/
Caregiver Engagement
and Education
Career Exploration
Community Trial Work
Experience:
Other:
Other:
Other:

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