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Program Registration Step 2
* required fields! Printable form

Please complete the following information and submit this form. Once the Best Companies Group receives this form, the primary contact will be sent a confirmation email with detailed information about the survey process.

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):
   
Additional Survey Options:
 
Does your company need alternate language surveys?*
Yes
No
* We offer employee surveys in a variety of languages. Additional languages are available at $205 per survey translation. If you need alternate language surveys, please select the above button and you will receive additional information. If you decide to pay online below, selecting yes to this section will automatically add the $205 to your bill.
 
If Other
Is your company interested in customizing the job role and department category demographics on the employee survey?
Yes, I am interested in receiving more information.
There is a fee of $795 to customize. What is this?
 
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:
   
Please be aware that as part of the “Best” program, a certain threshold of employee survey responses must be received in order for the analysts to consider the survey data valid. If a company does not meet this threshold, their full consideration for the “Best” list may be jeopardized, even resulting in elimination. In the rare case a company’s response rate is extremely low, a statistically valid Employee Feedback Report will not be presented.
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
 
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