Standard Vendor Application - YS

Division of Vocational Rehabilitation Services (DVRS)

Standard Vendor Application - Youth Services

 

Please complete this application if you wish to provide vendor services for the New Jersey Department of Labor and Workforce Development, Division of Vocational Rehabilitation Services (DVRS).

To obtain your UEI (Unique Entity Identifier) number, visit sam.gov. To obtain your NJStart number, visit njstart.gov.

DVR-35

Vendor ID and Contact Information

Business Address

Is the business address the same as the mailing address?

Mailing Address

Business Information

Type of business or service for which you are applying (select all that apply)
Counties to be served (select all that apply)
Is this business classified as private?
Is the business classified as a non-profit?
Are you a new Out-of-School Youth Employment Services (OSYES) vendor or are you expanding your OSYES services?
Are you a new Pre-Employment Transition Services (Pre-ETS) vendor or are you expanding your Pre-ETS services?

Additional Questions (Youth Services)

Are you currently a vendor with DVRS?
Counties entity currently serves as NJ Vocational Rehabilitation Services vendor (check all that apply)
Are you applying to provide Work-Based Learning Experiences (WBLE), Internships, and/or Apprenticeships in at least three employer/businesses?
Is your entity offering a paid or unpaid internship? (Select at least one)

Financial Contact / Accountant Information

New OSYES Vendor Questions

Is the OSYES activity address the same as the one listed above?

Additional Questions (OSYES)

Counties you intend to serve with OSYES.
Check the service(s) you intend to provide.
Are you able to provide all services selected above to all counties selected above?

Attach the information below for each service you intend to provide.

  • Summary of training, detailed curriculum, program schedule, names of interest and/or ability tests and assessments (i.e., online, paper, self-administered), materials, equipment, media, technology (devices/apps), handouts, social media

  • Styles of instruction (interactive, group discussion, lecture, activities). Note: materials, supplies, gear, and clothing needed for programs such as Work-Based Learning Experiences must be of no cost to consumers

  • Details about how you would address various learning styles and what methods you would use for each service

  • Estimated timeline for services, including hours per lesson/ topic

  • Measurable goals and objectives for each program to be achieved by consumers. All goals must be measurable

  • Measures that will be used to evaluate the achieved service deliverables for each service including Pre- and Post-Assessments

  • List all secondary schools, vocational or technical schools, and two- and four-year postsecondary schools with whom you are affiliated, partner, or provide services. Provide a sample MOU or letter of agreement

  • Contact information for all Skills Trainers (work cell phone numbers and email addresses)

  • Explanation of the student referral process, recruitment, public relations, and marketing strategies. All students must be referred to the NJ DVRS local office before you can accept them into your program for services. It is the responsibility of the vendor to obtain the NJ DVRS Participant Identification Number (PID) prior to service delivery

  • Marketing materials

  • Details about background check process, drug screening, and training requirements

  • Any supplementary materials that may be beneficial

Additional requests:

  • Please list the names of direct service supervisors, staff, and skills trainers; county/ies where they work; and any language(s) other than English in which they are fluent (for example, American Sign Language/ASL, Spanish). Note: ASL service providers must have passed the NJ DVRS mandatory Sign Language Communication Evaluation (SLCE) testing prior to approval, or they will need to take the test within three months of service start date.
  • Provide professional resumes for Supervisors and Skills Trainers, including copies of college transcripts, diplomas, foreign degree evaluations, licenses, or certifications, etc.
  • Provide documentation confirming education and experience of OSYES Staff, including a diploma from an accredited college or university with an associate degree, bachelor’s degree, or master’s degree in human services, psychology, sociology, education, social work, or related field, as well as a resume indicating two years of experience working with people with disabilities, students, and youth.
  • Provide documentation confirming background checks.

Expanding Out-Of-School Youth Employment Services Questions

New Pre-ETS Vendor Questions

Is the Pre-ETS activity address the same as the one listed above?

Additional Questions (Pre-ETS)

Counties you intend to serve with Pre-ETS.
Check the service(s) you intend to provide.
Are you able to provide all services selected above to all counties selected above?

Attach the information below for each service you intend to provide.

  • Summary of training, detailed curriculum, program schedule, names of interest and/or ability tests and assessments (i.e., online, paper, self-administered), materials, equipment, media, technology (devices/apps), handouts, social media

  • Styles of instruction (interactive, group discussion, lecture, activities). Note: materials, supplies, gear, and clothing needed for programs such as Work-Based Learning Experiences must be of no cost to consumers

  • Details about how you would address various learning styles and what methods you would use for each service

  • Estimated timeline for services, including hours per lesson/ topic

  • Measurable goals and objectives for each program to be achieved by consumers. All goals must be measurable

  • Measures that will be used to evaluate the achieved service deliverables for each service including Pre- and Post-Assessments

  • List all secondary schools, vocational or technical schools, and two- and four-year postsecondary schools with whom you are affiliated, partner, or provide services. Provide a sample MOU or letter of agreement

  • Contact information for all Skills Trainers (work cell phone numbers and email addresses)

  • Explanation of the student referral process, recruitment, public relations, and marketing strategies. All students must be referred to the NJ DVRS local office before you can accept them into your program for services. It is the responsibility of the vendor to obtain the NJ DVRS Participant Identification Number (PID) prior to service delivery

  • Marketing materials

  • Details about background check process, drug screening, and training requirements

  • Any supplementary materials that may be beneficial

Additional requests:

  • Please list the names of direct service supervisors, staff, and skills trainers; county/ies where they work; and any language(s) other than English in which they are fluent (for example, American Sign Language/ASL, Spanish). Note: ASL service providers must have passed the NJ DVRS mandatory Sign Language Communication Evaluation (SLCE) testing prior to approval, or they will need to take the test within three months of service start date.
  • Provide professional resumes for Supervisors and Skills Trainers, including copies of college transcripts, diplomas, foreign degree evaluations, licenses, or certifications, etc.
  • Provide documentation confirming education and experience of Pre-ETS Staff, including a diploma from an accredited college or university with an associate degree, bachelor’s degree, or master’s degree in human services, psychology, sociology, education, social work, or related field, as well as a resume indicating two years of experience working with people with disabilities, students, and youth.
  • Provide documentation confirming background checks.

Expanding Pre-Employment Transition Services Questions

Provide statistics for the last three years, through the date of application submittal.

Were deliverables met (year 1)?
Were deliverables met (year 2)?
Were deliverables met (year 3)?

E-Signature

By signing below, I am electronically signing this application and verifying that the information submitted is correct. This electronic signature has the same legal effect as a written signature.