Employer Eligibility Form Please Tell Us About You and Your OrganizationName of Company*Product/Service*Representative Name* First Last Representative Phone*Representative Email* Local Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Website* About the Job/InternshipPlease copy/paste full job/internship description*Briefly describe candidate requirements, recruitment and selection process.*How many openings will you be hiring for?*TrainingDo you provide training for your hires?*YesNoDescribe any out-of-pocket costs to new hires for training*If new hires leave for any reason, is reimbursement for cost of training required?*YesNoEmployment StatusIs the new hire hired as W-2 employee or 1099 contractor?*W-21099Other -- UnpaidCompensationPlease describe compensation plan including compensation while training.*Is there a base salary provided?*YesNoDoes compensation include draw on commission?*YesNoAre signed promissory notes or other similar documentation required?*YesNoIs there an expectation of repayment should the new hire leave for any reason?*YesNoIs a signed contract required as a condition of employment?*YesNoPlease describe your compensation structure including commission, bonus, and profit sharing*How is compensation explained during the hiring process?*Is this compensation information supported by printed documentation provided to new hires?*YesNoIs any portion of compensation dependent on hiring others?*YesNoBenefitsDescribe the company provided benefits.*Upfront Costs and ExpensesDoes the employer cover office expenses including office space and furniture, phone, supplies, cell phone, etc.?*YesNoPlease describe any out-of-pocket expenses, upfront costs and expenses required of employees/contractors*Signature (Name)*PhoneThis field is for validation purposes and should be left unchanged.