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* 1. Company Name:

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* 2. County:

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* 3. Industry:

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* 4. Contact Person:

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* 5. Title:

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* 6. Phone Number:

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* 7. Email Address :

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* 8. Do you anticipate employment growth in the next 12- 24 months?

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* 9. Will you be adding new technology, processes or equipment in the next 12 -24 months?

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* 10. Would you be interested in meeting with a Workforce Representative to evaluate your company's needs?

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* 11. Would you be interested in learning about what WIOA - Business Services can do for your company?

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