Registration Deadline: December 3, 2021

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Your Program Registration Starts Here 

Before completing the registration form on the following page, we need you to agree and commit to the following statements. The form will not submit until all fields are filled out completely.

 

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First name needed.

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Title needed.

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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.

 

Organization Information

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

 

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Mailing Address

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If no, please fill out the corporate address below.

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Please indicate if your company has more than one location in Kentucky. Please give us no more than two locations, any more than two and, due to space constraints, we will need to list your location as “multiple cities.” If you make the "best" list, this information will be used in promotional items including news releases to the media, the awards event, special publication, etc.

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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.

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

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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.

 

Contact Information

Tell us about your people.

 

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

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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.

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

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

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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.

 

Survey Selection

 

Participation Fees

Your registration fee depends on how many employees you have at your organization. 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 Employees Number
of Eligible Employees Surveyed
Online Method Cost* Paper Method Cost*
15-149 All** $1,050 $1,500
150-499 Up to 300*** $1,350 $2,200
500-999 400*** $1,550 $2,300
1000 and above 500*** $1,550 $2,300

*Costs are not refundable. **To ensure result credibility, companies with 15-24 employees are required to have at least an 80% response rate to be considered for the list. ***Employees are randomly selected.

 
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While we recommend online surveys in most cases, sometimes paper is a better option. If more than 40% of your employees do not have their own email address, please select "paper" below.

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Survey Additional Employees? For employee populations over 300 we survey a random selection or, would you like to survey additional employees?

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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.

 

Additional Information

Tell us about your survey needs. 

 

Additional Languages Does your organization need alternate language surveys?

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We offer employee surveys in a variety of languages. Additional languages are available at $199 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 $199 to your cart, per language.

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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.

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Additional Questions

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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.

 

Submit Your Registration

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

 

0.00 USD

You have selected to be invoiced. An invoice will be sent to the primary contact of this registration form from the Kentucky Chamber of Commerce for the registrations fees. Any additional services (alternate languages, customizations, additional survey requests, etc.) will be invoiced by Workforce Research Group.

 

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.

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