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ETPL POLICY AND PROCEDURES ATTACHMENT 3 <br /> ETPL LOCAL BOARD DELEGATION AND CANCELATION FORM <br /> A Local Workforce Development Board (Local Board) may delegate or cancel responsibility of the <br /> California (CA) and local Eligible Training Provider List (ETPL) to an appointed Local Board by <br /> completing this form. This form must be completed at the time of a change (delegation or <br /> cancelation), and annually in July to ensure the State ETPL Coordinator is able to coordinate with <br /> the appropriate Local Board. <br /> Please sign (physical or electronic) and submit the completed form to the Employment <br /> Development Department via email to WSBETPL@edd.ca.gov. <br /> Select either the Delegation or Cancelation box: <br /> - DELEGATION—Delegating Local Board is assigning responsibility for the CA and local ETPL <br /> to the Appointed Local Board, and the Appointed Local Board agrees to coordinate the CA and <br /> local ETPL on behalf of the Delegating Local Board. Signatures are required of the Delegating and <br /> Appointed Local Board's Executive Director. <br /> • CANCELATION—Delegating Local Board is revoking responsibility for the CA and local ETPL <br /> to the Appointed Local Board. The Delegating Local Board will resume responsibility for the CA <br /> and local ETPL unless a new Local Board is assigned this responsibility. Signatures are required of <br /> the Delegating and Appointed Local Board's Executive Director. <br /> Delegating Local Board: a, ' <br /> Delegating Local Board Executive Director <br /> Name: Signature: Date: <br /> Appointed Local Board: <br /> el.;e ere <br /> Appointed Local Board Executive Director <br /> Name: Signature: Date: <br /> WSD21-03 Page 1 of 1 <br />