Re-Employment Funding Application
Thank you for your interest in the Lower Shore 4E Partnership. Currently, the partnership pays 50% of wages for four weeks for a newly hired or rehired employee. This form covers the hiring of one employee. Future funding requests will require a new application and LSWA approval. Only one application may be submitted at a time.

Please provide the requested information below to be considered for re-employment funding. Answer "N/A" to any question that does not apply to your business.
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Email *
SECTION A: CONTACT INFORMATION
Legal Business Name *
Business Street Address *
City, State, and Zip Code *
Contact Person *
Position Title *
Phone Number *
SECTION B: BUSINESS INFORMATION
Business Website/URL *
Federal Employer Identification Number (EIN) *
Are you registered in the Maryland Workforce Exchange? *
Which sector best describes your business? *
What does your business do? Please explain *
Current Number of Employees *
SECTION C: RE-EMPLOYMENT INCENTIVE INFORMATION
Calculated at 50% of wages for four weeks, how much funding do you need for this position? *
What is the job title and duties for this position? *
What is the new hire's salary? Please indicate whether the amount is per hour, week, month, year, or other time period. *
Type of Employment *
Anticipated Start Date *
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