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Document Number: DETW-17123
Description: The Dislocated Worker Survey is completed by individuals who may lose or have lost their jobs due to a business closing or mass layoff. Information gathered in this survey is used for re-employment, retraining, research and economic development purposes.
Comments: The survey form is distributed only by DWD and Wisconsin's 11 Workforce Development Boards. The survey is completed by hand using a black or blue pen. Pencils should not be used. Workforce Development Board representatives return the completed surveys to:
Department of Workforce Development
Division of Employment and Training
Dislocated Worker Unit, GEF 1 - E100
201 E. Washington Ave.
P.O. Box 7972
Madison, WI 53707
Content Contact: WIOATitleI@dwd.wisconsin.gov
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.
DWD Contact Information
201 E. Washington Ave
P.O. Box 7946
Madison, WI 53707
(608) 266-3131
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