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PRACTITIONER EMPLOYMENT ASSISTANCESUPPORTED EMPLOYMENT APPLICATION PROVIDER IDENTIFICATION Last Name: First Name: Middle Name: Social Security Number (SSN) Required: Date of Birth: Contact Person:

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What is supported employment application?

Supported employment application is a form used by individuals with disabilities to apply for job placement assistance and support services.

Who is required to file supported employment application?

Individuals with disabilities who are seeking job placement assistance and support services are required to file a supported employment application.

How to fill out supported employment application?

Supported employment application can be filled out by providing personal information, disability information, work experience, and any specific job preferences.

What is the purpose of supported employment application?

The purpose of supported employment application is to help individuals with disabilities find suitable job placements and receive necessary support services.

What information must be reported on supported employment application?

Information such as personal details, disability information, work experience, and job preferences must be reported on supported employment application.

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