Exemplary Employer Recognition Award  - Application
Exemplary Employer Recognition is presented by the Wisconsin Family and Caregiver Support Alliance to recognize Wisconsin employers supporting employees who have family caregiving responsibilities outside the workplace. Employers of all sizes may apply. Applications will be scored based on workplace flexibility, resources for caregivers, financial and job supports available to employees, workplace culture, and communication between employees and employer.  More info about award and how to apply


Questions in this application are divided into 7 sections.  To preview the sections and questions, you may browse through the application after filling in your email. Please answer all questions or respond with 'not applicable'. At the end of the application you may choose to get a copy of your responses sent to the email that you provided.
Sign in to Google to save your progress. Learn more
About the Organization and employees
Your name and job title (You are the nominator and the person completing this application.) 
Your phone number (Needed in order to communicate with you.)
Name of Organization, Business, or Employer as it should be used in award communications
Name and job title of contact within organization you are nominating. (Needed in order to communicate with the organization about this award.)
Email of contact within organization you are nominating. (Needed in order to communicate with the organization about this award.)
Phone of contact within organization you are nominating.
Organization address
Street Address Line 2
Organization City
State
Zip code
Which Industry best fits your organization?
Describe the organization you are nominating. Include mission, products, target customers, service or distribution area.
Describe the size of your organization by total number of employees.
Clear selection
To the best of your knowledge or estimation, what percentage of your employee population has family caregiving responsibilities outside of the workplace? (include care for children, parents, spouses, siblings, or others needing personal or supportive care.)
Clear selection
How did you determine the above percentage.
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report