Workforce Express Intake Form

Company Name:

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Contact Person:

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Contact Person Title:

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Email Address:

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Phone Number:

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Business Address:

Address Line 1

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Address Line 2

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City

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State

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Postal Code

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Country

Number of Employees (in Massachusetts):

Primary Business Goals: (Briefly describe your company’s main objectives and how digital skills training can support them.)

Skill Improvement Areas:

Social Media Marketing

Website Development/Maintenance

Data Analysis/Reporting

Search Engine Optimization (SEO)

E-commerce/Online Sales

Digital Advertising (Google Ads, Social Ads)

Content Creation (Blogging, Video)

Project Management (Digital Tools)

Other (Specify Below)

If Other, Specify Here:

Specific Skill Gaps: (Describe any specific digital skill gaps you’ve identified within your team.)

Desired Training Outcomes: (What specific results do you hope to achieve from the training?)

Training Timeline: (Do you have a preferred timeframe for starting training? (e.g., ASAP, within 1 month, within 3 months))

Number of Trainees:

Have you confirmed your business eligibility for the Express Program via Step 1 on our info page?

Yes

No

Do you have a valid Certificate of Good Standing from the Massachusetts Department of Revenue (issued within the last 6 months)? If YES please be sure to email this to us!

Yes

No