Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
I am interested in
*
Career Services
Business Services
SoInAccess
Name of Business
*
Website
I am interested in the following Business Services (check all that apply)
*
Recruitment
Business Incentives
Labor Market Info
Layoff Assistance
Other (please explain below)
County of Residence
*
Please Select
Clark County
Crawford County
Floyd County
Harrison County
Scott County
Washington County
Other
Age Range
*
Please Select
Under 17
17–24
25–55
55–75
Over 75
If County is "Other" please list.
I am interested in the following Career Services (check all that apply)
*
Employment
Training
Workshops
Hiring Events / Job Fairs
Purdue University – Work From Home Classes
Prosser – Classes / Training
Other (please explain below)
I am interested in joining the SoInAccess Employer Network and am interested in the following populations (check all that apply)
Individuals with Disabilities
Justice Involved Individuals
Newcomers to America
I am interested in supporting the SoInAccess Initiative (check all that apply)
Become an ambassador
Share a success story
Participate in a focus group
Make a financial contribution
Message
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