1. Yes, I want to be a part of the solution! I plan to fill the following job opening(s) in the near future:
	Job Title #1 Number of Openings Anticipated Hire Date Estimated Hourly Wage Is this a newly created position? (Y/N) Job Title #2 Number of Openings Anticipated Hire Date Estimated Hourly Wage Is this a newly created position? (Y/N)

	2. I am already a part of the solution! I recently filled the following job(s):
	Job Title #1 Date of Hire Hourly Wage Was this a newly created position? (Y/N) Job Title #2 Date of Hire Hourly Wage Was this a newly created position? (Y/N)

	3. Your Contact Information
	Business Name Business Address Business Phone Business Email Company Website

	4. For validation purposes, please enter your Federal Employer ID number.

	5. Are you willing to have your business publicly recognized for your participation in "Frederick WORKS! One Job at a Time?"
	YesNo

	6. Thank you for being a part of the unemployment solution for Frederick County! We appreciate your involvement in this initiative. Please let us know if you have any comments, questions, or suggestions.