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Company Contact Information

First name*

Last name*

Email*

Contact Job Title*

Phone number*

Company name*

Street address*

City*

State/Region

Postal Code*

Rapid Response Presentation Information

You are currently requesting an IN-PERSON event. To request a virtual event, please use the Virtual Rapid Response Request Form.

Requested Event Date

Events are typically scheduled at least a month in advance, however, we will do our best to accommodate all requests. Large groups may choose multiple sessions per event date. If multiple dates are needed, please indicate under "Requested Time."

Month-Day-Year

Requested Time

You may request more than one session for groups of 20 or more. To request a specific event time, please discuss your needs with your COWIB Business Services Consultant.

9:00 - 10:30 am

11:00 am - 12:30 pm

1:00 - 2:30 pm

3:00 - 4:30 pm

Morning

Afternoon

Full Day

I need multiple event dates

Are employees/attendees being laid-off or furloughed?

Laid-off

Furloughed

Some laid-off, some furloughed.

Please list the job titles being laid-off with the current average wage of each title.

We will use this information to refer attendees to other employers who are hiring in our area.

Please share any information you have regarding your employees' commuting patterns and where they may be interested in finding new employment.

Who will be the company contact to assist on-site with the event?

Unemployment Insurance

The following questions will assist in making the unemployment presentation specific to attendees.

Last date of employment:

If not the same for all attendees, please give details below.

Month-Day-Year

Details of employee separation date(s):

Will they receive severance pay? If so, what amount and how will it be paid? (Lump sum, weekly, bi-weekly, etc.)

Will they receive profit sharing, 401k, or retirement?

Health Coverage

Please answer the following questions about health benefits to guide the presentation for the Oklahoma Insurance Dpt.

When will the current group insurance end?

Date of Termination

End of the Month of Termination

End of the 2nd Month of Termination

Are they eligible for COBRA?

Yes