New Business Registration Form

New Business Inquiry Form

"Solutions To Help Reentry Work Better"
Section I. Contact Information
Contact Name*

First NameLast Name
Contact Phone Number*
Email Address*
Company Name
Company Website
www.example.com
Company Type?
Industry?
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Section II. Business related questions
Briefly describe your company. What are your products and services?
What is your company's mission? Core values?
In general, what is the biggest staffing challenge that your company faces?
How do you currently attract and recruit job candidates?
Section III. Fair Chance Hiring

Equitable practices that aim to level the playing field and give justice-impacted job seekers a fair opportunity to secure employment.
Does your company currently have Fair-Chance hiring policies in place?*

YesNoNot sure
What is your company's motivation for adopting Fair Chance Practices? *
If applicable, how do you support your justice involved employees?
What is your company's top concern in hiring people with past convictions?

Lack of Work HistoryLimited Training or EducationReference ChecksCandidate FitRetentionBrand PerceptionNegligent HiringOther
If other, please explain.
Tell us how IEJI can support your Fair Chance Hiring effort?
Book Appointment
Preferred Meeting Style?

In-personVirtual (i.e.. Zoom, Microsoft Teams, Google Meet)No preference
Date Signed

MonthDayYear
Date
Signature

Clear
Should be Empty:

New Business Inquiry Form