Indiana Career Connect Staff Training
System Registration Templates
Please use the following information to create practice profiles for training.
Individual System Registration (WP & WIOA Adult/DW)
Section Name
Field Name
Data Entry Details
Login Information
Username
Password
Security Question/Response
Create using blue text guidelines
Use system-generated default
Your choice
Social Security
Number
SSN
521-66-10XX, where XX is trainer-assigned
Primary Location
Information
ZIP Code
Authorized to Work in U.S.?
46204 (for Indianapolis, IN)
Yes
Demographic
Information
Date of Birth
Gender
Selective Service Registration
Any month/Any date/1995 or earlier
Your choice
Yes if Male; System-set if Female
Name
First/Last Name
Your choice
Residential and
Mailing Address
Address Line 1
Your choice
Phone Numbers
Primary Phone/Phone Type
Your choice
Primary E-mail
First letter of first name/whole last
name/@email.com (i.e., John Smith
= [email protected])
Preferred
Notification Method
Method
Your choice
Site Access
Accessing website from?
Your choice
Citizenship
Citizenship
Citizen of U.S. or U.S. Territory
Disability
Do you have a disability?
No
Education
Information
Highest Level Achieved?
Are you attending school?
High School Diploma (or more advanced)
No
Employment
Information
Current Employment Status
Type of Business Worked in
Receiving UI benefits?
Looking for work?
Termination or Separation?
Date
Not Working
Private Business
No, neither claimant nor exhaustee
Yes
Yes
Your choice
Farm Worker
Last 12 months
Your choice
Email Address
ICC Staff Training – System Registration Templates V1.0
Training Dates: ___________________ Training Location: ____________________________
Page 1
Section Name
Field Name
Data Entry Details
Desired Job
Desired Job Title
Occupation Title
Accessing site from
Chef
Chefs and Head Cooks
Your choice
Ethnic Origin
Hispanic or Latino Heritage?
Race
Your choice
Your choice
Language
Primary spoken language
Your choice
Military Service
Various Questions
Your choice (if Yes, data entry required)
Public Assistance
Various Questions
# Individuals in Household
Income for last 6 months
Maintain ‘No’ defaults
4
$2000.00
Employer System Registration
Section Name
Field Name
Data Entry Details
Employer
Identification
FEIN
558-36-24XX, where XX is trainer-assigned
Username
Password
Security Question/Response
Create using blue text guidelines
Create using blue text guidelines
Your choice
Company Name
Your choice (restaurant/eatery)
Primary Location Info
ZIP Code
Street Address
46204 (for Indianapolis, IN)
Your choice
Mailing Address
Mailing Address
Your choice
Job Title
First/Last Name
Primary Phone
Email Address
Preferred Notification Method
Company Website
Owner or Manager
Your choice
Your choice
First letter of first name/whole last
name/@email.com (i.e., John Smith
= [email protected])
Your choice
Your choice (not required)
Company Info
Industry Title (NAICS)
No of Employees
Type of Employer
Federal Contractor?
Staffing Firm?
Full-Service Restaurant (722110)
Your choice
Private Sector
No
No
Company Profile
Company Profile
Make one up
Benefits Offered
Company Benefits
Your choice
Login Information
Employer
Identification
Contact Information
ICC Staff Training – System Registration Templates V1.0
Training Dates: ___________________ Training Location: ____________________________
Page 2
Individual System Registration (WIOA Out-of-School Youth)
Section Name
Field Name
Data Entry Details
Login Information
Username
Password
Security Question/Response
Create using blue text guidelines
Use system-generated default
Your choice
Social Security
Number
SSN
518-29-71XX, where XX is trainer-assigned
Primary Location
Information
ZIP Code
Authorized to Work in U.S.?
46204 (for Indianapolis, IN)
Yes
Demographic
Information
Date of Birth
Gender
Selective Service Registration
02/02/2000 (16 yrs old!)
Female
N/A (system-set)
Name
First/Last Name
Your choice
Residential and
Mailing Address
Address Line 1
Your choice
Phone Numbers
Primary Phone/Phone Type
Your choice
Primary E-mail
First letter of first name/whole last
name/@email.com (i.e., John Smith
= [email protected])
Preferred
Notification Method
Method
Your choice
Site Access
Accessing website from?
Your choice
Citizenship
Citizenship
Citizen of U.S. or U.S. Territory
Disability
Do you have a disability?
No
Education
Information
Highest Level Achieved?
Are you attending school?
10th Grade (High School Dropout)
No
Employment
Information
Current Employment Status
Type of Business Worked in
Receiving UI benefits?
Looking for work?
Termination or Separation?
Date
Never Worked
N/A
NO, neither claimant nor exhaustee
No
N/A
Your choice
Farm Worker
Last 12 months
Your choice
Desired Job
Desired Job Title
Occupation Title
Accessing site from
N/A
N/A
Your choice
Ethnic Origin
Hispanic or Latino Heritage?
Your choice
Email Address
ICC Staff Training – System Registration Templates V1.0
Training Dates: ___________________ Training Location: ____________________________
Page 3
Section Name
Field Name
Race
Data Entry Details
Your choice
Language
Primary spoken language
Your choice
Military Service
Various Questions
Your choice (if Yes, data entry required)
Public Assistance
Various Questions
# Individuals in Household
Income for last 6 months
Food Stamps
N/A
N/A
Individual System Registration (TAA)
Section Name
Field Name
Data Entry Details
Login Information
Username
Password
Security Question/Response
Create using blue text guidelines
Use system-generated default
Your choice
Social Security
Number
SSN
575-02-33XX, where XX is trainer-assigned
Primary Location
Information
ZIP Code
Authorized to Work in U.S.?
46204 (for Indianapolis, IN)
Yes
Demographic
Information
Date of Birth
Gender
Selective Service Registration
Any month/Any date/1966–1995
Your choice
Yes if Male; System-set if Female
Name
First/Last Name
Your choice
Residential and
Mailing Address
Address Line 1
Your choice
Phone Numbers
Primary Phone/Phone Type
Your choice
Primary E-mail
First letter of first name/whole last
name/@email.com (i.e., John Smith
= [email protected])
Preferred
Notification Method
Method
Your choice
Site Access
Accessing website from?
Your choice
Citizenship
Citizenship
Citizen of U.S. or U.S. Territory
Disability
Do you have a disability?
No
Education
Information
Highest Level Achieved?
Are you attending school?
High School Diploma
No
Employment
Information
Current Employment Status
Type of Business Worked in
Receiving UI benefits?
Looking for work?
Not Working
Private Business
Yes, claimant, not profiled and referred
Yes
Email Address
ICC Staff Training – System Registration Templates V1.0
Training Dates: ___________________ Training Location: ____________________________
Page 4
Section Name
Field Name
Termination or Separation?
Date
Data Entry Details
Yes
Your choice
Farm Worker
Last 12 months
Your choice
Desired Job
Desired Job Title
Occupation Title
Accessing site from
Chef
Chefs and Head Cooks
Your choice
Ethnic Origin
Hispanic or Latino Heritage?
Race
Your choice
Your choice
Language
Primary spoken language
Your choice
Military Service
Various Questions
Your choice (if Yes, data entry required)
Public Assistance
Various Questions
# Individuals in Household
Income for last 6 months
Maintain ‘No’ defaults
4
$2,000.00
Remember Your Login Information!
Account Login
Username / First Name
Password / Last Name
Individual Login (WP & WIOA)
Employer Login (WP)
Individual Login (WIOA Youth)
Individual Login (TAA)
Staff Login Information
iccstaff_______
Training@1
ICC Staff Training – System Registration Templates V1.0
Training Dates: ___________________ Training Location: ____________________________
Page 5