ETR Company Profile Form

Company Profile

In order to provide you with better service, please take a few minutes to complete this form.
Submission of this form will automatically send your information to Employment & Training Resources.

To whom at ETR would you like this information sent?

Company Information
Company Name
DBA (Doing Business As, if different)
Street Address
Mailing Address (if different)
City
State
Zip
Main Telephone Number
Web Address
Primary Product or Service
NAICS Code (Free NAICS Lookup Service)
Number of Employees at this location
FEIN (Federal Employer Identification Number)
Type of Company
Are you a Federal Contractor?	Yes No
Company Benefits Available (Please check all that apply)	No Benefits 401K Bonuses Child Care Referral Resources Child Care Services Reimbursement Clothing Allowance Dental Insurance Education Cost Reimbursement Employee Discount In_House Skills Training Programs Life Insurance Long Term Disability Major Medical Mileage Reimbursement	On_Site Child Care Paid Holidays Prescriptions Retirement Plan Short Term Disability Sick Leave Subsidized Skills Development (e.g., ESOL, Adult Education) Uniforms Furnished Vacation Leave Vehicle Furnished Vision Insurance Other (Please specify)

Contact Information
Contact Name
Title
Telephone (including extension)
Fax
E-mail Address

How did you hear about Employment & Training Resources?

Would you be interested in participating in a job fair or recruitment?	Yes No

Would you like more information from one of our Business Service Representatives?	Yes No

Comments?

If you experience problems with this form, please consider using the MS Word version of the form, or contact Diane for assistance
(781-769-4120, ext 114, DMarvelle@detma.org)

Page last updated on March 03, 2010

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ETR Marlborough 508-786-0928	ETR Newton 617-928-0530	ETR Norwood 781-769-4120