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� <br /> ETPL POLICY AND PROCEDURES ATTACH M5NT3 <br /> _------------------_-------_________� -__ -� -'-- ��-----�--' —�----------'------ -----? <br /> ETPL LOCAL BOARD DELEGATION AND CANCELAT[ON 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 th is form.Th is form m ust be completed at the tim e of a ch a nge(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 /> EDDELEGATION—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 forthe CA and local ETPL 11 <br /> | <br /> to the Appointed Local Board, The Delegating Local Board will. resume responsibility forthe CA � <br /> and |000| ETPL unless e 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: <br /> Delegating Local Board Executive Director <br /> Name: Signature. Date: <br /> Appointed Local Board: <br /> Appointed Local Board Executive Director <br /> Signature: Date: <br /> L--_'-------------------------------------�------- <br /> Pm�� �nfl <br /> VV5D21'O3 <br />