HRIS and Benefits Qualification Questionaire

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Name*

First NameLast Name
Company Name*
Occupation or Industry *
Choose State*
Phone Number*
Preferred Method of Contact*

PhoneEmailEither
E-mail*

Congratulations Your Approved!

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1. Schedule Discovery Call to Set Up Complimentary HR Platform & Employee Benefits

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2. Submit Approval Decision using button below

Sorry Your Not Approved
Due to one of the reasons below, you do not qualify for our complimentary Human Resource Platform. Feel free to reach out for any issues or concerns using the link below:

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Disqualifing Factors:
- Less than 3 employees
- Not looking to offer/ replace employee benefits
- Company is not partially located in United States
Should be Empty: