Company
Name (Company name as it should appear in print):
|
* |
Legal
Name of the Company (If different than listed
above.): |
|
Federal
Employer Identification Number (FEIN): |
|
Mailing
Address:
(No home addresses) |
* |
City: |
* |
County: |
* |
State: |
|
Zip Code: |
* |
Company Website URL: |
* |
Industry: |
* |
Industry Other: |
|
|
Primary
Contact
(This person will be the main contact
for questions throughout the entire process
and the recipient of all communications (via
emails, phone calls, website and letters, employee
surveys for distribution, feedback reports,
etc.)
|
Salutation: |
* |
First Name: |
* |
Last Name: |
* |
Title:
|
* |
Mailing
Address:
(No home addresses) |
* |
City: |
* |
State: |
|
Zip
Code: |
* |
Direct
Dial Phone Number:
(No home or cell phones please) |
* |
Fax
Number: |
* |
Email
Address: |
* |
|
Secondary
Contact (This person will be the contact
for questions if the primary contact is unavailable.) |
Salutation: |
|
Name: |
|
Title: |
|
Direct Dial Phone
Number:
(No home or cell phones please) |
|
Email Address: |
|
|
CEO,
President, Manager, Etc. (Highest-ranking
position in the state of the nominated workplace.) |
Salutation:
|
|
Name: |
|
Title: |
|
Mailing
Address:
(No home addresses) |
|
City: |
|
State: |
|
Zip
Code: |
|
Direct Dial
Phone Number:
(No home or cell phones please) |
|
Email
Address: |
|
|
IT
Contact (This person will be the contact
for any technical systems questions regarding
online surveys - for all employer questionnaires
and online surveys for employees - regarding
filtering, spam content, white-listing, etc.) |
Salutation: |
* |
Name: |
* |
Direct Dial Phone Number:
(No home or cell phones please) |
* |
Email Address:
|
* |
|
Marketing/PR
Contact (This person will handle any
marketing and/or public relations questions
for your company.) |
Salutation: |
* |
Name: |
* |
Title: |
* |
Direct Dial
Phone Number:
(No home or cell phones please) |
* |
Email
Address: |
* |
|
Additional
Company Information: |
Total
number of employees in Rhode Island and Bristol County, Massachusetts (excluding
temporary/seasonal and per diem employees). |
Total
Employees: |
* |
Full-time
Employees: |
* |
Part-time
Employees: |
* |
Total
number of employees in the United States (excluding
temporary/seasonal and per diem employees). |
Total US
Employees: |
* |
Full-time
Employees: |
* |
Part-time
Employees: |
* |
*
Participation fee:
The fees are based on the size of the
company and the selected survey method.
|
 |
Number
of Employees in RI and Bristol County, MA |
#
Employees Surveyed |
Online
Fee(1) |
Paper
Fee(1) |
|
15
- 24(2)
|
All |
$735 |
$965 |
|
25 - 99 |
All
|
$760
|
$1,135 |
|
100 - 199
|
All |
$860 |
$1,365 |
|
200 - 499 |
Up to 250(3) |
$910 |
$1,495 |
|
500 - 2499 |
350(3) |
$980 |
$1,665 |
|
2500 + |
400(3) |
$1,020 |
$1,860 |
|
(1) Fees
are non-refundable.
(2) To ensure the credibility of the
information, companies with 15-24
employees must have an 80% (or better)
response rate to be considered for
the list.
(3) Employees are randomly selected.
|
|
*
Survey Type: Please
select what kind of survey you would like
to receive. |
Online
Employee Survey (Electronic): |
|
Paper
Employee Survey (Hard Copy): |
|
|
|
|
|
Questionnaire:
|
How did you hear about the
program? |
|
If Other |
|
|
|
Did you participate last
year? |
|
If yes, Name of the company
if it is
different than above: |
|
|
|
|
|
|
Name
of person completing this registration form: |
Your
Name: |
* |
Your
Title: |
* |
Your
Email Address: |
* |
Are
you authorized to enter your
company into this process: |
* |
Commitment: |
* I
understand that by clicking this submit button,
our company is entered into the "Best Places
to Work in Rhode Island" program. I am committing
to meet all deadlines, complete both portions
of the assessment process and pay the registration
fee. If at any point we choose to withdraw from
the process, we will notify a representative of
Best Companies Group at 1-877-455-2159 immediately.
Companies withdrawing after February 23, 2018,
will incur a $250 withdrawal fee in addition to
the total fees incurred for any special requests
(customization orders, language translations,
paper survey processing, etc.) and the registration
fee. All fees are non refundable. |
IMPORTANT:
If any of the contact information changes
at any point in the process, please notify
Jennifer Aquiler at JenniferA@bestcompaniesgroup.com
immediately. |
|
Payment
Options: |
*
Payment: |
Pay online now
Invoice |
In
order to submit this form, please input the
verification code as listed below, and click Submit Request. Please note that the page will time
out if you have had the page open for an extended
period of time.
*
Check the information you have entered, then
click Submit |
|