Unemployment Benefits Survey

First Name *

Last Name *

City *

State *

Email *

Phone *

Were you terminated/laid off at any point within the last two years? *

Thank you for your interest in this matter. The survey is intended to gather information from individuals who have been terminated/laid off at any point over the past two years.

When were you terminated/laid off? - Optional

Describe your previous employer. - Optional

Sheltered Workshop

Other

Had you been laid off/terminated by this employer before? - Optional

Describe. - Optional

Did you file for unemployment benefits? - Optional

If not, why not? - Optional

I was told that I was not eligible.

Other Reason

By whom? - Optional

Describe. - Optional

If yes, did you encounter barriers with the application process? - Optional

Was the applicant process inaccessible with screen access software? - Optional

Describe the screen access software barriers you encountered. - Optional

What other barriers did you encounter? - Optional

Was your application for unemployment benefits approved? - Optional

If not, for what reason was your application denied? - Optional

Have you returned to work? - Optional

Are you currently seeking employment? - Optional

If not, why not? - Optional

What do you need to return to work? - Optional