Provider Forms

Provider Forms

The forms below must be submitted via email to the ita@careersourcepbc.com email address.


Acceptance Letter - This form must be submitted before a prospective student can be issued an Individual Training Account (ITA) voucher. Please use the Acceptance Letter Guide to help you fill out the form.

Student Training Status - This progress report must be submitted by the 10th of each month.

Date Change Request - All date change requests will be reviewed and approved/denied by the Workforce Innovation and Opportunity Act (WIOA) manager. The total number of days that a completion date can be extended cannot exceed 90 days.

Training Outcome Form - This form must be submitted once the student has completed the full program; along with a copy of the ITA voucher, the last invoice, and a copy of the certificate or diploma.

Our Centers

Central Career Center
3400 Belvedere Road
West Palm Beach, FL 33406
561.340.1060

West Career Center
1085 South Main Street
Belle Glade, FL 33430
561.829.2040

Delray Career Cottage - CLOSED
186 NW 5th Ave
Delray Beach, FL 33444
561.727.3399