Name*

Job Title*

Company Name*

Phone Number*

E-mail*

What industry is your company in?*

How many employees does your company hire on an annual basis?*

How many locations does your company have?*

Do your applicants apply for positions on a paper application, web-based or both?*

Roughly what percentage of your new hires are hourly paid workers?*

Does your company have any large call centers, distribution centers or warehouses?* -- Please Select -- Yes No

If yes, how many of those locations are there?

Does your company currently screen your employees for tax credit eligibility?* -- Please Select -- Yes No

If so, when are they screened (prior to hire or during onboarding)?