2. Employer Telework Program Assistance Request Form

   Pierce County has hired a telework consultant to provide free telework program assistance. Complete this form and a representative will contact you to explain the employer assistance program within 48 hours. Employer worksites receiving the assistance must be located in Pierce County or Thurston County.

4. First Name*
5. Last Name*
7. Work Email*
8. Work Phone Number
10. Company*
11. Street Address
13. City
14. ZIP Code
16. How did you hear about the Telework Program Assistance? I received a phone call, LinkedIn, Facebook, Twitter, friend, family, colleague, other?
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field