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For Businesses
Clackamas Coordinated Business Services (CCBS)
Quality Jobs Initiative
Rapid Response
Construction
Childcare And Early Learning
Healthcare
Manufacturing
Technology
For People
WorkSource Clackamas
Unemployment Services
Youth Ages 14-24
Workforce Partner Network
Expungement Clinics
Our Impact
Board Policies, Resolutions And Bylaws
Equity And Diversity
Procurement And RFPs
Capacity Building Recovery Assistance
Sources And Uses
Trends, Data And Annual Reports
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WorkSource Clackamas
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For Businesses
Clackamas Coordinated Business Services (CCBS)
Quality Jobs Initiative
Rapid Response
Construction
Childcare And Early Learning
Healthcare
Manufacturing
Technology
For People
WorkSource Clackamas
Unemployment Services
Youth Ages 14-24
Workforce Partner Network
Expungement Clinics
Our Impact
Board Policies, Resolutions And Bylaws
Equity And Diversity
Procurement And RFPs
Capacity Building Recovery Assistance
Sources And Uses
Trends, Data And Annual Reports
About Us
Meet the Board
Board Application
Public Notices & Meeting Minutes
Blog
Contact Us
Contact Us
Donate
Menu
For Businesses
Clackamas Coordinated Business Services (CCBS)
Quality Jobs Initiative
Rapid Response
Construction
Childcare And Early Learning
Healthcare
Manufacturing
Technology
For People
WorkSource Clackamas
Unemployment Services
Youth Ages 14-24
Workforce Partner Network
Expungement Clinics
Our Impact
Board Policies, Resolutions And Bylaws
Equity And Diversity
Procurement And RFPs
Capacity Building Recovery Assistance
Sources And Uses
Trends, Data And Annual Reports
About Us
Meet the Board
Board Application
Public Notices & Meeting Minutes
Blog
Contact Us
Contact Us
Donate
Search
Search
Close this search box.
Donate
Employer-Employee Assistance Assessment
Employer-Employee Assistance Assessment
Date of incident leading to closure or loss of job?
Business/worksite address (physical location, not PO Box):
Business or Employer
Personal Information
Please select the box that best represents you: *
I am completing this form as the “Employer”
I am completing this form for myself as a “Worker”
Are the affected workers union-represented?:
Yes
No
If yes, provide the union and name and contact information of the union representative:
Number of affected workers:
Industry type (manufacturing, construction, business services…):
Indicate if you are a Clackamas County businesses owned by: Women, Black, Indigenous, and People of Color (BIPOC), First Nations and Tribal members, Immigrant and non-native English speakers, LGBTQ+ identified, People with Disabilities, and Veterans. Please check all that apply:
Women
Black, Indigenous, and People of Color (BIPOC)
First Nations and Tribal members
Immigrant and non-native English speakers
LGBTQ+ identified
People with Disabilities
Veterans
Please provide a brief description of your situation and current needs
Send