Your application date is set on the date you complete an interview, or the date we receive this Registration form with your name, address and signature. Homeless persons do not have to give an address. However, the entire application process, including filling out this Registration from, filling out the Application, completing an interview and signing the Application, must happen before you can receive benefits or services. We will tell you in writing within 30 calendar days whether you are eligible. It is important to set your application date as soon as as your can do that you can get benefits and services as quickly as possible. Providing or applying for a social security number (SSN) is voluntary; however, any person who wants public assistance but does not provide an SSN or apply for one will not be eligible for benefits. SSNs and personally identifiable information will be used only for the direct administration of public assistance programs. Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m), Wisconsin Statutes].
- W-2: You will meet with a Resource Specialist on the day you give this signed Registration form to the W-2 agency or the next work day. Payments or services may begin effective date of your placement in a W-2 employment position.
- Refugee Case Assistance (RCA): Eligibility begins on the application date. Payments are prorated for the first and last month’s benefits. The initial payment must be made within five working days following determination of eligibility and each monthly payment shall be made by the first of the month thereafter.
If you need help filling out this Registration form, contact the local agency listed here. If you have a disability and need access to this application in an alternate format, or need it translated to another language, contact the local agency listed below. These translation services are free of charge.
Forward Service Corporation
Corporate Office Address: 4600 American Parkway, Suite 301 Madison, WI 53718
[Authorization of Participant Representative form (DCF-F-DWSP2375) must also be complete.]
- Please look at the Benefits and Services Offered at Wiscosnin Works (W-2) Agencies (DCF-P-DWSP11890) brochure to read about benefits and services that may be available to you and your family.
- Please look at the What to Bring with You (DCF-F-DWSP2372) brochure to see what you will need for the interview. When applying, you may be asked to provide proof of information such as: age, identity, Social Security number, citizenship status, income and assets for all persons applying for information. This brochure will help you get the right documents for the interview.