Employment Partnership Enrollment Form
Company Name
*
Company URL
*
Number of Employees
*
Describe your internal and external customers.
*
Place of Business
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Partnership Type
*
Full-Time Employment
Part-Time Employment
Contractual
Probono/Career Internship
Employment Needs (You may select more than one)
*
Administrative
Customer Service
Data Entry
Event Planning/Coordination
Graphic Designer
Program Coordination
Training Coordination
Business Analysis
Program Management
Back-Office Support
Other
Your Company Profile (less than 150 words)
*
0/150
Company Specialization Keywords (Separated by comma)
*
e.g Accounting, HR, Payroll, Taxation, E-commerce, et
0/150
Can we publish your business as an employment partner on our website?
*
Yes
No
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Partnership Point of Contact
Contact Name
*
Email Address
*
Confirmation Email
example@example.com
Phone Number
*
The contact person on this form is acting as an agent on behalf of the prospective business partner. Signing this form attests the information entered is true to the best of their knowledge.
*
Please sign to attest to the validity of the content provided on this form.
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