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?* Yes No Describe any out-of-pocket costs to new hires for training*If new hires leave for any reason, is reimbursement for cost of training required?* Yes No Employment StatusIs the new hire hired as W-2 employee or 1099 contractor?* W-2 1099 Other -- Unpaid CompensationPlease describe compensation plan including compensation while training.*Is there a base salary provided?* Yes No Does compensation include draw on commission?* Yes No Are signed promissory notes or other similar documentation required?* Yes No Is there an expectation of repayment should the new hire leave for any reason?* Yes No Is a signed contract required as a condition of employment?* Yes No Please 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?* Yes No Is any portion of compensation dependent on hiring others?* Yes No BenefitsDescribe the company provided benefits.*Upfront Costs and ExpensesDoes the employer cover office expenses including office space and furniture, phone, supplies, cell phone, etc.?* Yes No Please 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.