PRIVACY NOTICE, TERMS, PROGRAM POLICIES AND PERSONAL DATA CONSENT

The below describes what personal information Skills for Chicago collects and how we use this personal information. Skills for Chicago takes vigorous measures to protect your personal information. This includes our websites, in-person at any of our Skills for Chicago locations or at any event a representative of Skills for Chicago is attending. Skills for Chicago's full Privacy Policy and Equal Opportunity Employment Policy are available on its website.

EQUAL EMPLOYMENT OPPORTUNITY POLICY

Skills for Chicago provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Skills for Chicago’s full Equal Employment Opportunity Policy is listed on its website.

All employers Skills for Chicago partners with also abide by equal employment opportunity policies.

BUSINESS INTERMEDIARY RELEASE

Skills for Chicago does not have the final hiring decision in regard to employment opportunities with its employer partners. Skills for Chicago does not guarantee employment while using or after using any of its services or programs. Skills for Chicago is not responsible or liable for the immediate or future employment or termination of employment and its personal impact on the candidate with any of its employer partners.

MEDIA RELEASE

I acknowledge that by engaging with Skills for Chicago from the below date and beyond, I may be the subject of various media (e.g., motion picture, audio recording, still or video device photography) which may be used by Skills for Chicago in connection with the distribution, advertising, publicity or promotion and/or other exploitation of Skills for Chicago. I hereby consent to the creation of such media and to such usage of this media, and further grant to Skills for Chicago the unrestricted right to use, publish, and/or reproduce any and all such media.

I hereby waive any and all rights to privacy and publicity with respect to such media and hereby waive any right that you may have to inspect and/or approve the finished product or the advertising copy that may be used in connection therewith or the use to which it may be applied. I further release and forever discharge Skills for Chicago, their successors, affiliates, licensees, assigns, agents and legal representatives from any and all claims and liability related to or arising from the rights granted above to Skills for Chicago.

EMPLOYMENT DATA CONSENT AUTHORIZATION

I authorize my employer obtained via Skills for Chicago, to release information that supports Employment Eligibility Verification as would suffice on an I-9 to Skills for Chicago.  I further release and hold harmless both Skills for Chicago and my employer from any and all liability that may potentially result from the release and/or use of such information. I understand that any information released by my employer and what I share with Skills for Chicago personally will be held in strictest confidence and secure. I authorize Skills for Chicago to release a copy of a copy of the following records pertaining to my demographic and employment information:

·       Total dollar amount of wages by quarter as reported by my former employers for the last three completed     quarters.

·       Beginning and ending dates of most recent valid UI claim and claim award (weekly and maximum benefit     amount), claim balance, and whether I have exhausted my benefits.

·      Last employer name and address, last date worked, and whether laid off due to lack of work.

·      Any demographic information provided above will be used anonymously and in aggregate.

·      Additional information available from the Illinois Department of Employment Security, the Chicago       Department of Family and Support Services, the Chicago Cook Workforce Partnership, or other local or       federal workforce agencies or programs.

DATA SHARING CONSENT

In compliance with grant stipulations, to measure program performance outcomes, and to research program impacts, Skills for Chicago may share my personal information with trusted partners.  Trusted partners include, but are not limited to, collaborating workforce organizations, supportive service organization, evaluation partners, audit and compliance agencies, educational institutions, local government agencies, federal government agencies, and researchers at the University of Chicago and other universities.  These partners may also link my personal information with other sources for the purposes of evaluating program impacts.  Data sharing agreements are in place with these and future partners to safeguard the candidate's personal information and the information will not be connected to identify the individual publicly without additional written consent.  No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. All the above categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties

THE DEPARTMENT OF FAMILY AND SUPPORT SERVICES RELEASE OF INFORMATION AGREEMENT

A requirement of this program is for follow-up to be conducted after receiving services through our program(s) to receive feedback on how this program helped you and to ensure you have retained employment. You will be contacted over 30 days up to a minimum of 180 days after you exit from this program. Program Staff will ask follow up questions to gauge how you are doing. Some questions may include asking about your employment situation and if you are in need of any other services.

This follow up is very important to our agency and for the future of other program participants. To ensure we can maintain contact with you, please be sure to notify our agency if there is a change to your contact information.

I certify that the above information is accurate. As a participant in a Chicago Department of Family and Support Services sponsored program, I hereby authorize my employer to release information regarding my employment to the DFSS Workforce Services Division and contracted agency, Skills for Chicago. This information will be used for confirming employment at placement, 30-day retention, and/or 90-day retention and may be shared with grant funders, DFSS and stakeholders.

I voluntarily agree to provide information to Skills for Chicago follow up staff including but not limited to my program experience and or outcomes and my employment situation. I understand that the information I provide will be shared with the grant funder, Department of Family and Support Services, and other stakeholders.

I certify that the information provided on this Enrollment form and Assessment form for eligibility in the program is accurate. In addition, I agree to cooperate with the Department of Family and Support Services and all contracted agencies and program staff while I participate in Skills for Chicago's programming.

I do hereby certify that the information contained with this Individual Employment Plan (IEP) is correct and that I along with program staff at Skills for Chicago worked on the development of my IEP to participant in the employment program. I hereby grant permission for Skills for Chicago to share the content of this IEP with the grant funder, Department of Family and Support Services and stakeholders. 

I have received information concerning the Illinois Child Support Enforcement Services. I was provided with information concerning the regional locations within the State in accordance with the counties served where I may apply. I understand that it is my responsibility to seek further services, if appropriate. (Illinois Child Support 

Info Center) 

CONFIDENTIALITY NOTICE: I certify that the information listed above is accurate and true to the best of my knowledge. This notice is for the sole use of the intended recipients. It contains confidential information. Under Penal Code 502 and Civil Code 1798.53 any review, use, disclosure, or distribution of the content of this document is prohibited and subject to criminal penalties/fines.

I certify that the information completed on previous pages and above is accurate to the best of my knowledge and I agree to the statements listed above.