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Please complete the following information and submit this form. Once the Best Companies Group receives this form, you 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 Web Site 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, Web site 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 Vermont (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 Vermont
# Employees Surveyed
Online Fee(1)
Paper Fee(1)
 
15 - 24(2)
All
$740
$970
25 - 99
All
$765
$1,140
100 - 199
All
$865
$1,370
200 - 499
Up to 250(3)
$915
$1,500
500 - 2499
350(3)
$985
$1,670
2500 +
400(3)
$1,025
$1,865
(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 on the employee survey to be considered for the list. (3) Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing.
* 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 Vermont" program. I am committing to meet all deadlines, complete both portions of the assessment process and pay the participation 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 November 3, 2017 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.
IMPORTANT: If any of the contact information changes at any point in the process, please notify Katrina Heimbach at KHeimbach@BestCompaniesGroup.com immediately.
Payment Options:
* Payment:
Pay online now
Invoice via email

In order to submit this form, please input the verification code as listed below. Once the code is entered, please 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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