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DGIP Client Placement Form - for Employers
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Company Name
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Company Address
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Provide name, email, and phone number for the point of contact
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Specify your type of business
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If you checked 'other' above ( or would like to provide more detail about the type of business you operate), use the space below to further describe your business.
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Duration of time you expect to host an apprentice
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Number of applicants you would be willing to accept  
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Please indicate the earliest date applicants and job coaches could start.
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Does this job require apprentices to be able to lift a minimum weight? If yes, what is the minimum weight?
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Does the job require a MN driver's license?
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Describe any additional requirements for placement at your organization that may be needed for apprentices and job coaches.
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Have you hired Deaf or Hard of Hearing individuals before?
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Have you previously employed individuals that needed workplace accommodations?
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