Tompkins Workforce Development Board's Disabilities Workforce Committee is conducting this survey to determine how we can better support and understand the needs of employers with regard to individuals with disabilities.

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* 1. Do you currently employ anyone with a disclosed disability?

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* 2. Which disability accommodations have you provided for employees in the past?

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* 3. Which disability accommodations are you currently able to provide for employees?

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* 4. How would you rate your retention of employees with disclosed disabilities?

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* 5. Please select the topics on which you would like more information and/or advisement:

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* 6. Please rate your knowledge of the following:

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Americans with Disabilities Act (ADA)
Reasonable workplace accommadations
Disability in the workplace
Hiring incentives
Awareness of disability service providers
Recruitment resources and support

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* 7. Please submit any additional comments or questions:

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* 8. What is the name of your business?

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* 9. Are you interested in being contacted about resources, support, and workshops?

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* 10. What is the best phone number for us to contact?

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* 11. What is the best email for us to contact?

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* 12. Please provide the name of the contact person:

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