The Pennsylvania Workforce Coalition is a partnership initiated by PA APSE consisting of State Agencies and statewide membership organizations to increase employment and advancement of people with disabilities. While we work on a larger event for Spring 2022, we wanted to start connecting people sooner.

Do you identify as a person with a disability? If yes, please keep reading.

Are you looking for a job?
Want to learn more about an industry?
Want to have conversations with industry professionals to learn tips to advance your career?

If you answered YES to at least one of those three questions, please continue on with this survey.

We are hosting virtual events this October to help connect YOU with businesses. We will contact you regarding the day(s) based on your interests and needs.

We are accepting interest until Friday October 8th, so please be sure to submit by this time.

Please allow 15 minutes to complete this form. You will need a valid email address. If any part of this form is inaccessible for you, please contact us at PaWorkforceCoalition@gmail.com.

For additional resources, please visit www.PACareerLink.pa.gov.


*If you are a friend or family member of a person who identifies as having a disability, please share this with them.

*If you are an Employment Support Professional or other staff within the field, please discuss this possibility with those you support.

*If you know of a business in Pennsylvania who may be interested in being part of this event in October or learn more about the Spring event, please have them contact us at PaWorkforceCoalition@gmail.com.


For additional questions or to request an accommodation to complete this form, please contact the PA Workforce Coalition at PaWorkforceCoalition@gmail.com.

Collaborative Partners of the PA Workforce Coalition include:
PA APSE (Association of People Supporting EmploymentFirst)
Office of Long-Term Living (OLTL)
Office of Developmental Programs (ODP)
Office of Mental Health and Substance Abuse Services (OMHSAS)
Office of Vocational Rehabilitation (OVR)
PA Department of Labor & Industry
PA Workforce Development Board (includes PA CareerLink®)
PA Training and Technical Assistance Network (PaTTAN)
RCPA (Rehabilitation and Community Providers Association)
PAR (Pennsylvania Advocacy and Resources for Autism and Intellectual Disability)
PA Chamber of Business and Industry
PA Chamber for Black-Owned Business

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* 1. Email Address - This will be the form of contact with next steps.

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* 2. Please share your first and last name.

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* 3. What pronouns do you use?

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* 4. If someone is filling out this form in collaboration with the person whose name was shared above, please share that name here. By submitting information, you confirm you are completing this form with the person and the individual has given you both consent and the authority to share this information on their behalf.

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* 5. Which county in Pennsylvania do you live in?

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* 6. Tell us a little more about you. Select all that apply to you.

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* 7. Select all that apply to you.

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* 8. Why are you interested in attending this event? Select all that apply.

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* 9. What type of work are you interested in? Select all that apply.

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* 10. Select your top 3 needs in your next job.

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* 11. What are your top 3 strengths and / or skills?

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* 12. If you had a dream employer, who would that be? Why? If you don't know, share that.

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* 13. How far are you willing and able to travel for work?

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* 14. What type of support would you like? Select all that apply.

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* 15. Do you have a resume? If so, please upload.

PDF, DOC, DOCX, JPG, JPEG file types only.
Choose File

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* 16. If you did not upload a resume, please share about your paid and unpaid/volunteer experiences, as well as your skills, here.

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* 17. Do you use any of the PA CareerLink® services? Example - workshops, have a Workforce Advisor/Career Coach, search for jobs on the PA CareerLink® website. www.PACareerLink.pa.gov

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* 18. Do you currently have a job coach or receive employment services?

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* 19. The event will be closed captioned, which also provides a transcript. Please share if you need other accommodations to participate in a virtual event.

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