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Employer Name*   First Name of person contacted*   Last Name of person contacted*   Email Address of employer if applicable   Date you contacted the employer*   Employer's Street Address*   City*   State*   Zip*   Area Code*   Phone Number*   Did you contact your Job Coach?*   Yes   No      If you did not contact your job coach, please explain why (if you contacted your job coach, please type N/A in the space provided)::*     Type N/A if you contacted your job coach or type your explanation for not contacting your job coach.  Â