The Long-Term Care Foundation The Adult Family Home Training Network Worker Sponsorship Pilot Program

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The cost of the training and—for certain specified training—employee salary and benefits during the training, will be paid by The Long-Term Care Foundation from a portion of the training benefit negotiated for Adult Family Homes in the collective bargaining agreement with the State of Washington.
Information collected from this application will be part of a data analysis of the pilot program

Adult Family Home Name(Required)
Address(Required)
Adult Family Home Contact (person to help manage sponsorship process):(Required)
Is your adult family home approved to offer on-the-job training?(Required)
Do you currently have a Medicaid contract?(Required)
Do you have an applicant that you would like to sponsor through one or more qualifying training?(Required)
Sponsored Applicant:(Required)
Address(Required)
Student Date of birth
Hire Date/Intend to Hire Date
Race(Required)
Gender(Required)
Disability:(Required)
Military Veteran:(Required)
Does the applicant have previous health care experience?(Required)
Does the applicant currently hold any certifications?(Required)
Please check off what the applicant has completed below to work in Adult Family Home:(Required)
Which of the trainings below are needed for applicant to become a long-term care worker?(Required)
Which of the trainings below are needed for applicant to further long-term care worker professional and career development?(Required)
Which of the following DSHS-approved training companies will you choose to provide the training you require?
Is the applicant able to take the training online?(Required)
Applicant's Highest Grade Completed:(Required)
How did you hear about us?
Date(Required)