* 1. What is the name of the organization applying to be a WorkSource Connection Site?

* 2. Please identify the names and titles of all staff who will be assigned to the Connection Site.

* 3. What is the email address for the primary contact?

* 4. Are you applying on behalf of an entire system (i.e. Seattle Public Library) or are you applying as a specific site (i.e. Seattle Public Library: Ballard Branch)?

* 5. Does your organization currently have a website?

* 6. If you have a website, what is the website address?

* 7. What is the physical address of the proposed WorkSource Connection Site? If you are including multiple locations, please provide all location details.

* 8. What hours and days is your proposed site(s) currently open?