Employer Video Stories: FAMLI Division
We appreciate your interest in participating in the Family and Medical Leave Insurance (FAMLI) video testimonial project. FAMLI is planning to feature a series of employers in testimonial videos. These videos are aimed at letting people know how FAMLI has impacted or benefited certain employees and/or employers. Our team coordinate a meeting with you to talk about your participation. Please fill out the form below if you'd like to be featured.
Sign in to Google to save your progress. Learn more
Email *
Do you have permission to speak on behalf of your company? If not, please provide the contact information for someone who does.
*
Please share with us how implementing FAMLI has helped your organization. 
*
Do we have your consent to participate in the employer's video series project, which may require recording, audio, or digital conversation via Zoom and other platforms? Please write (Yes/No) or any other concerns you may have below. *
I understand that any recorded statements may be used by the Colorado Department of Labor and Employment’s marketing efforts, or any other medium of communication (including newsletters, social media, newspapers, magazines, television, radio, pamphlets, brochures, reports, CDLE websites and other digital communications), without any liability on the part of the Colorado Department of Labor and Employment, its departments and/or employees. I understand that my photo or testimonial provided is being conducted with my permission and consent (and that of the organization I represent), and I assume full responsibility for the release of information about me and/or the organization I represent. I hereby grant CDLE permission to use my likeness in a photograph, video, or other digital media in any and all of its publications and with partners, including web-based publications, without payment or other consideration.
*
Do you give the FAMLI Division permission to contact specific employees who have taken FAMLI leave to share their story? *
If you answered yes to the above question, please share their contact information.
Thank you for your time. We hope to connect soon.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of State.co.us Executive Branch.

Does this form look suspicious? Report