Employment First  Survey

This Information obtained will support the employment advocacy work on behalf of persons with disabilities in the NWI Region.

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* 1. Are you a recent

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* 2. Do you need support in any of these areas? (Check any and all that apply)

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* 3. What are some of the barriers to your getting a job?

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* 4. If you could work from home (check all that apply)

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* 5. General information about you and your disability

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* 6. Indicate your age range

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* 7. What county do you live in?

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