Your Month, Your Day Application Form

Your Month, Your Day

YOUR MONTH, YOUR DAY FOR COMMUNITY EMPLOYMENT! To submit your entry for the Free CWLab "planning experience" for your organization, please provide your contact information – the person we would contact if your organization is selected as the winner. Also, please provide us with brief information about why your organization should be selected and how you might want to use the CWLab.

Please provide your contact information

First Name Required Question

Last Name

Title

Organization/Company Name Required Question

Address 1

Address 2

City

State

Zip Code

Email Address Required Question

Phone Number

Fax Number

URL

1. What does your organization do, or wish to do, in the area of community employment for people with disabilities? Required Question

2. Should your entry win, what idea(s) are you thinking about for making use of the CWLab experience? Required Question

3. Please add any other information about why your organization should be selected to receive a free Collaborative Wok Lab experience.

The Collaborative Work Lab @ Indiana University