2016 Participant Registration Form

Thank you for your interest in participating in the 2016 Best Companies to Work for in Colorado® program. Registration is fast and easy.

To participate, simply fill out this online registration form. If you close your browser without completing and submitting your form, your data will not be saved and you will have to start over. If you do not see a "Registration successfully submitted" confirmation screen, we have not received your completed application.

Once ModernThink receives this form, you will be sent a confirmation email message with information about next steps.

If any of the contact information supplied below changes at any point in the process, please notify the ModernThink Project team at ColoradoBest@modernthink.com.

*All fields are required

Today's Date *

Month

Day

Year

Company Information

Company Name *

Company Name as it should appear in print

Legal Name of the Company

If different from above

Mailing Address *

City *

County *

State *

Zip Code *

Company Web Site URL *

NAICS Code and Industry *

Primary Contact

This person will be the main contact for questions throughout the entire process and the recipient of all program communications.

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.

Name *

Title *

Direct Dial Phone Number *

Email Address *

IT Contact

This person will be the contact for connectivity testing and any related technical questions.

Name *

Title *

Direct Dial Phone Number *

Email Address *

Additional Company Information

Total number of employees in Colorado
(excluding temporary, seasonal and per diem employees)

Total Employees *

Full-time Employees *

(must have at least 25 in Colorado to participate)

Part-time Employees

(employees working at least 20 hours per week - these employees should be included in your sample)

Participation fee

The primary contact will be invoiced according to the size of the company and the selected survey method.)

Fee Description

Size	# of Employees	# Employees Surveyed	Online Fee	Paper Fee
Small	25-99	All	$688	$962
Medium	100 - 249	All	$853	$1128
Large	250 - 399	250*	$1018	$1293
Large (400+ employees)	400 or more	400*	$1018	$1293

*randomly selected
For paper surveys, there is an additional $2.50 processing fee per survey sent.

Fee *

Please make your selection based on the description above in the table.

Survey Administration

Survey Method *

**Please note that if you participate using a combination of paper and online surveys, you will be charged the paper survey participation fee for your company size (noted above), as well as the $2.50 processing fee per paper survey sent.

Is your company interested in customizing the Job Role and Department demographics on the employee survey? *

Did you participate last year? *

How did you hear about the program? *

IMPORTANT Please be aware that as part of the Best Companies to Work for in Colorado® 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 list may be jeopardized.

I understand that hitting the submit button enters our company into the 2016 Best Companies to Work for in Colorado® program and that being considered for recognition requires completion of the ModernThink Infrastructure and Practices Inventory; as well as the ModernThink Insight Survey. If at any point we choose to withdraw from the process, we will notify ModernThink at 1-888-684-4658 as soon as possible. Registration fees are non-refundable and will be invoiced upon registration.

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2016 Participant Registration Form

SHRM Colorado State Council