Partnership Engagement Form
What is your organization's official name?
Organization's Mailing Address
City
State
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AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
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MD
MA
MI
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MS
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MT
NE
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OH
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OR
PA
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SC
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TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip code
Organization's Website Address
Organization's Phone Number
Industry
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Accommodation and Food Services
Administration, Business Support and Waste Management Services
Advisory and Financial Services
Agriculture, Forestry, Fishing and Hunting
Arts, Entertainment and Recreation
Construction
Consumer Goods and Services
Educational Services
Finance and Insurance
Healthcare and Social Assistance
Industrial Machinery, Gas and Chemicals
Information Technology
Manufacturing
Mining
Non-profit
Other Services (except Public Administration)
Professional, Scientific and Technical Services
Real Estate and Rental and Leasing
Retail Trade
Specialist Engineering, Infrastructure and Contractors
Staffing
Transportation and Warehousing
Utilities
Wholesale Trade
I understand that all information shared will be added to SERJobs' confidential database.
The partnership will be structured as
:
Community Partner
Donor (donation or grants)
Employer Partner
Training Partner
Volunteer
Email
Services Provided
(select all that apply):
Advisory Committee
Citizenship & Immigration Resources
Clothing Resources
Counseling Services Resources
Financial Empowerment Services
Food Resources
Funding Home Buyer Education
Health Resources
Housing Resources
Internship Hosts
Legal Services Resources
Parenting Resources
Printing
Senior Resources
Training
Veteran Resources
Vital Record Replacement Resources
Volunteers
Women Resources
Youth Resources
Other
Other services provided not listed:
Advisory Committee - Service
Advisory Committee
Citizenship & Immigration Resources
- Service
Citizenship & Immigration Resources
Clothing Resources
- Service
Clothing Resources
Counseling Services Resources
- Service
Counseling Services Resources
Financial Empowerment Services
- Service
Financial Empowerment Services
Food Resources - Service
Food Resources
Funding Home Buyer Education - Service
Funding Home Buyer Education
Health Resources
- Service
Health Resources
Housing Resources
- Service
Housing Resources
Internship Hosts
- Service
Internship Hosts
Legal Services Resources
- Service
Legal Services Resources
Parenting Resources
- Service
Parenting Resources
Printing
- Service
Printing
Senior Resources
- Service
Senior Resources
Training - Service
Training
Veteran Resources
- Service
Veteran Resources
Vital Record Replacement Resources
- Service
Vital Record Replacement Resources
Volunteers
- Service
Volunteers
Women Resources
- Service
Women Resources
Youth Resources
- Service
Youth Resources
Contact Information
(for the person completing this form)
First Name
Last Name
Work Email Address
Office Phone Number
Position Title
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Are you in communication with someone at SERJobs?
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No
What's the name of your Contact at SERJobs?
Please describe where this connection took place:
How did you hear about SERJobs?
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Activity
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Partner Engagement Form Completed
We greatly appreciate you taking the time complete our partnership application.
Contact Information