P4E Employer Partnership Interest Form

P4E Employer Partnership Interest Form
Organization / Company Name
Organization Type

Other
Website URL
Primary Contact Name

First NameLast Name
Title / Role
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address, City, & State

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
How did you hear about LOHM?
Which population(s) are you interested in supporting?

Other
What type of partnership are you interested in?

Other
Are you currently hiring?
What types of roles or industries are available? (e.g., tech, customer service, construction, healthcare, administrative)
Are you open to hiring justice-impacted individuals?
Do you offer any of the following?
Why are you interested in partnering with LOHM?
What values or goals does your organization have that align with LOHM’s mission?
What level of involvement are you seeking?
Is there anything else you would like us to know about your organization or partnership interest?
Preferred method of follow-up
Should be Empty: