Registration : Best Places to Work in PA

Registration

* required fields!

Please complete the following information and submit this form. Once the Best Companies Group receives this form, you will be sent a confirmation email and 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:	*
City:	*
County:	*
State:
Zip Code:	*
Company Web Site URL:	*
NAICS Code: *To find your code, Click Here
Industry:	*

Primary Contact (This person will be the main contact for questions throughout the entire process and the recipient of all communications (via emails, phone and letters), employee surveys for distribution, feedback reports, etc.)
Salutation:	*
First Name:	*
Last Name:	*
Title:	*
Mailing Address:	*
City:	*
State:
Zip Code:	*
Direct Dial Phone Number:	*
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:
Email Address:

CEO, President, Manager, Etc. (Highest-ranking position in the state of the nominated workplace.)
Salutation:
Name:
Title:
Mailing Address:
City:
State:
Zip Code:

Internal Contact (Person in your company who handles taxes and/or unemployment compensation for your company.)
Salutation:	*
Name:	*
Title:	*
Direct Dial Phone Number:	*
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:	*
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:	*
Email Address	*

Additional Company Information:
Total number of employees in Pennsylvania (excluding temporary/seasonal and per diem employees).
Total Employees:	*
Full-time Employees:	*
Part-time Employees:	*

* Participation fee: The primary contact will be invoiced according to the size of the company and the selected survey method.

Number of Employees In PA	Number of Employees Surveyed
25-99	All
100-199	All
200-499	Up to 250
500-2499	350
2500+	400

Number of Employees in PA	Online Fee*	Paper Fee*
25 - 250	$715	$915
Over 250	$915	$1,215
* Fees are non-refundable

* Survey Type: Please select what kind of survey you would like to receive.

Online Survey
(Electronic)

Paper Survey
(Hard Copy)

Additional Survey Options:

Does your company need alternate language surveys?*	* We offer employee surveys in a variety of languages. Additional languages are available at $195 per survey translation. If you need alternate language surveys, please select the above button and you will receive additional information.
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.

Questionnaire:

How did you hear about the program?

If other or name of newspaper

Did you participate last year?

Please be aware that as part of the “Best Places,” “Best Employers” or “Best Companies” 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 Places,” “Best Employers” or “Best Companies” 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.

Check the information you have entered, then click Submit

IMPORTANT: If any of the contact information changes at any point in the process, please notify Megan Burns at meganb@bestcompaniesgroup.com immediately.

NewPA.com (this link opens in a new browser window)