Registration Form

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Program Registration

Click here for a printable form.

Before completing the registration form on the following page, Best Companies Group (BCG) needs you to agree and commit to the following statements. The form will not submit until all fields are filled out completely and accurately.

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I have authorization from the executive(s) to enter this organization into the program.

You must agree to this statement.

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The organization I am registering meets the Eligibility criteria.

You must agree to this statement.

*

The organization must complete BCG's two part survey process including the Employer Benefits & Policies Questionnaire (EQ) and the Employee Engagement & Satisfaction Survey (EESS) according to the Timeline.

You must agree to this statement.

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The organization must receive a minimum number of responses on the EESS to ensure our data is credible. If not enough responses are received, our ability to be considered for the list or to receive a statistically valid BCG Insights Report package may be impacted.

You must agree to this statement.

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We understand that we are responsible for paying the non-refundable registration fee and for any other additional services ordered (customization, translation fees, additional reporting, etc). If we withdraw after May 28, 2021, we will incur an additional $250 withdrawal fee to remove our organization from the process.

You must agree to this statement.

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By entering my name below, I agree and commit to all of the above statements and confirm that I am authorized by the executive(s) of this organization.

You must agree to this statement.

First Name*

First name needed.

Last Name*

Last name needed.

Title*

Title needed.

Phone*

Valid phone needed.

Phone Extension

Invalid

Email *

Valid email needed.

If the form does not proceed to the next page, please review your information throughout the form to see what is missing or what needs corrected.

Organization Information Tell us about your organization. Please list the HQ or primary location for your operations in Maine.

Organization Name*

Response required.

Legal Name

Response required.

FEIN/Business Number

Valid response required.

Mailing Address

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

ZIP / Postal Code*

Response required.

Organization County*

Response required.

Website*

Valid response required.

Twitter Handle

Response required.

Industry*

Response required.

Other Industry*

Response required.

Is this the corporate address?*

Response required.

If no, please fill out the corporate address below.

Street Address*

Response required.

Address Line 2

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City*

Response required.

State*

Response required.

ZIP / Postal Code*

Response required.

Contact Information Tell us about your people.

Primary Contact The Primary Contact will be the main contact for questions throughout the entire process and the recipient of all communications (via emails, phone, website and letters), employee surveys for distribution, feedback reports, etc.

Salutation*

Response required.

First Name*

Response required.

Last Name*

Response required.

Title*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email *

Valid response required.

Confirm Email *

Valid response required.

Same as Organization Mailing Address Invalid Input

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

ZIP / Postal Code*

Response required.

Is this contact an employee of the company*

Response required.

Would the primary contact like to be contacted by ME SHRM to learn more about celebration event sponsorship opportunities?*

Response required.

Secondary Contact The Secondary Contact will be the contact for questions if the Primary Contact is unavailable.

Salutation

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First Name

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Last Name

Invalid Input

Title

Invalid Input

Phone

Invalid Input

Phone Extension

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Email

Invalid Input

If the form does not proceed to the next page, please review your information throughout the form to see what is missing or what needs corrected.

Contact Information Tell us about your people.

CEO, President, Manager, Etc. (Highest-ranking position of the nominated workplace.)

Salutation

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First Name

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Last Name

Invalid Input

Title

Invalid Input

Phone

Invalid Input

Phone Extension

Invalid Input

Email

Invalid Input

Same as Organization Mailing Address Invalid Input

Street Address

Invalid Input

Address Line 2

Invalid Input

City

Invalid Input

State

Invalid Input

Zip / Postal Code

Invalid Input

IT Contact The IT Contact 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*

Response required.

First Name*

Response required.

Last Name*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email*

Valid response required.

Marketing/PR Contact The Marketing/PR Contact will handle any marketing and/or public relations questions for your organization.

Salutation*

Response required.

First Name*

Response required.

Last Name*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email*

Valid response required.

Human Resources Contact Human Resources Contact will handle any human resources related questions for your organization.

Salutation*

Response required.

First Name*

Response required.

Last Name*

Response required.

Title*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email*

Valid response required.

If the form does not proceed to the next page, please review your information throughout the form to see what is missing or what needs corrected.

Number of Employees Tell us how many employees you have working in Maine.

If you employ more than 250 people, we will survey a random sample of your employees. Please enter the total number of employees (See Eligibility) working at this organization. Please do not include temporary, seasonal or per diem employees, PRN, 1099 employees/independent contractors, volunteers, interns, outside consultants or staffing employees placed by other organizations. (See Eligibility)

Full-time Employees in Maine*

Valid numbers needed.

Part-time Employees in Maine*

Valid numbers needed.

Total Employees in Maine*

Valid numbers needed.

You must have a total of at least 15 employees to continue.

Participation Fees

Your registration fee depends on how many employees you have at your organization and whether you choose the online or the paper employee survey process. See Online vs. Paper for more information. Please see the chart below to determine the survey selection, as well as the fees regarding organization size and survey method. You will receive an invoice at a later date or you can choose to pay online at the end of this form.

Number of Eligible ME Employees	Number of Eligible ME Employees Surveyed	Online Fee*	Paper Fee*
15 – 24**	All	$795	$1,105
25 – 99	All	$820	$1,275
100 – 199	All	$920	$1,505
200 – 499	Up to 250***	$970	$1,635
500 – 2499	350***	$1,040	$1,805
2500 +	400***	$1,080	$2,000
Fees are non-refundable. 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. **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.

While we recommend online surveys in most cases, sometimes paper is a better option. If more than 30% of your employees do not have their own email address, please select "paper" below.

*

Please select.

Number of Maine eligible employees as indicated above.*

Response required.

Number of Maine eligible employees as indicated above.*

Response required.

Survey Additional Employees? For employee populations over 250 we survey a random selection or, would you like to survey additional employees?

Yes, I'm interested Invalid Input

Please tell us about your United States employees. Please do not include temporary, seasonal or per diem employees, PRN, 1099 employees/independent contractors, volunteers, interns, outside consultants or staffing employees placed by other organizations.

Full-time Employees in the United States*

Valid numbers needed.

Part-time Employees in the United States*

Valid numbers needed.

Total Employees in the United States*

Valid numbers needed.

If the form does not proceed to the next page, please review your information throughout the form to see what is missing or what needs corrected.

Additional Information Tell us about your survey needs.

Does your organization need alternate language surveys?

*

Response required.

We offer employee surveys in a variety of languages. Additional languages are available at $215 per survey translation. If you need alternate language surveys, please select the languages below, and we will contact you to confirm your selections. Selecting "YES" above will add $215 to your cart, per language.

*

Spanish – Latin American - 215.00 USD

Spanish – European - 215.00 USD

Portuguese - 215.00 USD

French – Canadian - 215.00 USD

French – Creole - 215.00 USD

French – Parisian - 215.00 USD

Chinese - 215.00 USD

Japanese - 215.00 USD

Other Language - 215.00 USD

Please select.

Language Selector Other*

Please name.

Are you interested in customizing your employee survey? As part of the survey design process your organization has the option (for a fee) to customize the employee survey to include changing job roles/department selections, adding a location question, surveying all or additional employees and adding additional questions. If selected, you will be contacted by a survey specialist to learn more about these options.

*

Please select.

Additional Questions

Did this organization participate last year?*

Invalid Input

If yes, please list name of company if different than what is listed on this form.

Response required.

How did you hear about the program?*

Please select.

If Other*

Response required.

If the form does not proceed to the next page, please review your information throughout the form to see what is missing or what needs corrected.

Submit Your Registration You're almost done! (All fees are non refundable)

Total Fee

$0.00 USD

Payment Options

You have selected to be invoiced. An invoice will be sent to the primary contact of this registration form.

Billing Contact

First Name*

First name needed.

Last Name*

Last name needed.

Phone*

Valid phone needed.

Phone Extension

Invalid

Email for credit card receipt, if applicable*

Valid email needed.

Fax

Valid phone needed.

Billing Address

Same as Organization Mailing Address Invalid Input

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

ZIP / Postal Code*

Response required.

Credit Card Information

Credit Card Number

Invalid Input

Card Security Code (CSC)

Invalid Input

Card Expiry Month

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Card Expiry Year

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If the form does not proceed to the next page, please review your information throughout the form to see what is missing or what needs corrected.

Prove that you're human*

Response required.

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