ASPIRE - Employment Pilot Program Application
Organization Details
Name or Organization:
Primary Worksite Address:
Phone:
Fax:
Is your organization:
Non-Profit
Private For Profit
Public
Why is your organization interested in the Employee Pilot Program?
Contact Information
Primary Contact/Title:
Email:
Secondary Contact/Title:
Email:
Position Details
Worksite Supervisor/Title:
Email:
Phone Number:
Number of Positions Available:
Hours per Week:
Positions Description:
How will the participant be trained and evaluated once on the job:
What skills will the participant gain as a result of working for your organization?
CCAP, Inc.
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