Business Needs Assessment Form Please fill out the form below completely, OR CLICK HERE to download a fillable PDF. Business Needs Assessment Form How did you hear about WorkSource * Contact Name * Title Business Name * Business Street Address City State ZIP Phone * Extension Fax Email Address * Website/URL Federal Tax ID # * Standard Industry Code (SIC NAICS) Company's product or service Years in business This is a: Corporate/headquarters Branch # of Employees at this location What is the most significant factor affecting your business? Current BUSINESS ASSISTANCE needed (that could be provide through our partners or collaborators) Marketing/Marketing Assessment Business Plan/Cash Flow Management Financing/Access to Capital Permits/Licenses/Certification Labor Market Information Legal/Tax Consulting OtherOther What changes do you foresee in the next year? What changes do you foresee in the next 5 years? Do you have any particular hiring needs at this time? * Yes No If YES, may we contact you to get details? * Yes No How can we help with your staffing needs today? If no hiring needs, do you anticipate any over the next 6 months? Yes No # of Positions? Full Time? Yes No Part Time? Yes No Do you do the hiring? Yes No If no, who is responsible? How many openings currently? What are the main issues when considering hiring? Do you have any difficulty finding qualified employees? Yes No If no, please describe Any difficulty retaining qualified employees? Yes No Why? Do you hire ex-felons? Yes No If yes, how extensive? Do you provide benefits? Yes No If yes, what benefits? What type of training do you provide your employees? Current STAFFING, TRAINING, AND HUMAN RESOURCES assistance needed (provided by WorkSource): * Lay off/Downsizing services Job applicants Retention assistance Interview/Conference room New hire trainingNew hire training Current employee training (topics)Current employee training (topics) OFFICE USE ONLY (Steps recommended, referral and followup) reCAPTCHA If you are human, leave this field blank. Submit Equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.