Amplify! Success 2019
RequiredRequired Question(s)
1.
Please enter the information indicated below if you wish to be contacted and connected with resources or get involved.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com

2.
Please check the boxes below that specify your next steps and we will follow-up with you to help meet your needs!
Sit down with an Amplify! representative to learn more
Bring disability inclusion training to my workplace (multiple topics and providers available)
Recruit from a pool of job candidates with disabilities from local employment partners
Attend "The Business Advantage with Amplify!: Improving Your Bottom Line through Workplace Disability Inclusion" at BESThq on October 30, 2019 from 3-6pm
Connect to State of Oregon Vocational Rehabilitation, Oregon Commission for the Blind, and/or Employment
Learn more about our program partners, PHAME, Project SEARCH, Incight, and Best Buddies
Other  
Required 3.

On a scale of 1 to 4, 4 being excellent, how would you rate the event?

       
       
Required 4.

On a scale of 1 to 4, 4 being excellent, did the event inspire you?. 

       
       
Required 5.

Would you like information on becoming a participating sponsor for the next event, Amplify! Rock Stars on May 27th, 2020 at Embassy Suites by Hilton, Washington Square, Portland, Tigard?

Yes, count me in!
No thanks
6.

Comments or suggestions you wish to share?

 

350 characters left.
Required 7.

May we quote you for promotional purposes?

Yes
No