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CIE Review Request

CIE Review Request Form

This question requires a valid email address.
Are you requesting a CIE review for a position for which you are currently recruiting? *This question is required.
Instruction: Enter the name of the CRP by which the individual working in this position will be paid.
Instruction: Enter the name of the business where the individual in this position will work and provide the full address for this location.
Instructions: Please respond "True" or "False" for each question below.  For a position to qualify as competitive integrated employment (CIE), all items must be “True.” After all seven questions are addressed, a comment box will appear if one or more response is "False".  Use this comment field to explain why you responded "False".
1. The position pays an hourly wage at or above the state or local minimum wage rate, whichever is higher, for the area in which the employment site is located. *This question is required.
2. At no time will the wages paid for this position be subject to “time studies” to which non-disabled individuals are not subject. *This question is required.
3. An individual employed in this position will be eligible for the same level of benefits as non-disabled employees. *This question is required.
4. This position is and will continue to be available to the individual hired regardless of the service provider with whom the individual is connected. *This question is required.
5. This position is not located within a setting established for the sole purpose of employing individuals with disabilities. *This question is required.
6. The job duties of this position are not performed in a segregated environment in the community. The position provides the same opportunity for interaction with non-disabled individuals as experienced by non-disabled peers in the same or similar positions. *This question is required.
7. This position provides the same opportunities for advancement for individuals with the most significant disabilities as those available for non-disabled peers in the same or similar positions. *This question is required.If true, use the comments box below to describe the promotional opportunities available to individuals in this position.
Is this position funded by an AbilityOne or Maryland Employment Works contract? *This question is required.
This question requires a valid date format of MM/DD/YYYY.
Attach the position description, including job qualifications and essential functions. *This question is required.
Using your mouse, touchpad, or phone, sign below to affirm the certification that the above responses are true and correct and then press "Submit" to send this request.

By signing and submitting this review request as an authorized representative of the Community Rehabilitation Program identified as the Employer of Record, I hereby certify that the above representations with regard to a job position that meets the requirements of Competitive Integrated Employment are true and correct.  Failure to provide true and correct information will subject the Community Rehabilitation Provider to sanctions by DORS including loss of DORS funding to provide vocational rehabilitation services. *This question is required.
Signature of