The following form is to register for the Working Communities Challenge Employment Research Study. This study is only available to residents of SAWCC Region (Southern Windsor and Northern Windham counties in Vermont).

Please fill out the information below accurately. The information is needed to provide the $40 survey incentive. All responses for the surveys will be anonymous. Participant information will not be used for any other purpose beyond notification to complete a survey and receiving the incentive. 

Please contact Amanda Porter, WCC Coordinator, with any questions.

Question Title

* 1. Please enter the information below.

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