Registration Form

* Mandatory Fields

ORGANIZATION CONTACT INFORMATION

Organization (name in full) :

Address of the Headquarters in India :

City :

State :

Pincode :

Industry Type :

Organization Web Site :

Name of person submitting the nomination :

E-mail of person submitting the nomination :

CEO	Same as in Organization Contact Information

Name :

Designation :

Contact telephone number with Extension :

format : STD Code-Local Telephone number-ext (no space between numbers) E.g. 91-22-66105544

Mobile Number :

Fax Number :

E-mail Id :

Address if different from company address :

H R Head

Same as in Organization Contact Information

Name :

Designation :

Contact Telephone Number with Extension :

format : STD Code-Local Telephone number-ext (no space between numbers) E.g. 91-22-66105544

Mobile Number

Fax Number :

E-mail:

(You will receive an autoreply email on submission of this form)

Address if different from company address :

PRIMARY CONTACT

Same as in H R Head

Same as in Organization Contact Information

The primary contact will be the main contact for questions throughout the entire process and the recipient of all communications, distribution of employee survey, coordination of management questionnaire completion, etc

Name :

Designation :

Mobile Number :

Contact Telephone number :

format : STD Code-Local Telephone number-ext (no space between numbers) E.g. 91-22-66105544

Contact Extension :

Fax Number :

E-mail ID :

(You will receive an autoreply email on submission of this form)

Address if different from company Address :

SECONDARY CONTACT (optional)

Same as in Organization Contact Information

Will be the contact point for queries, if the primary contact is unavailable.

Name :

Designation :

Mobile Number

Contact Telephone Number :

format : STD Code-Local Telephone number-ext (no space between numbers) E.g. 91-22-66105544

Contact Extension :

Fax Number :

E-mail :

Address if different from company address :

IT HEAD CONTACT

Name :

Designation :

Mobile Number

Contact Telephone Number :

format : STD Code-Local Telephone number-ext (no space between numbers) E.g. 91-22-66105544

Contact Extension :

Fax Number :

E-mail :

Address if different from company address :

Contact details for GPTW Study Results Communication

Please give contact details of 2/3 persons who should be informed about whether your Company ranks or does not rank in the list of Best Companies to Work For in our study. This information when imparted by Great Place to Work® Institute India will be confidential and should be restricted to the top management team in your company till the Award Event.

Same as in CEO Contact Details

First Contact Name :

Designation :

E-mail ID :

Same as in H R Head Contact Details

Second Contact Name :

Designation :

E-mail ID :

Third Contact Name :

Designation :

E-mail ID :

ELIGIBILITY INFORMATION

(A)How many regular, full-time employees do you currently have working in India (EXCLUDING temporary and seasonal employees) :

(B)How many regular, part-time employees do you currently have working in India (EXCLUDING temporary and seasonal employees) :

Total Number of Employees working in India:(A+B) :

Comments on full-time/part-time employee numbers :

Number of years of operations in India :

years*

Is your company currently going through, or has gone through a merger or acquisition in the last 12 months, or is planning a merger or acquisition in the next 6 months that has added/ will add 25% or more to your workforce?

You came to know about the “India’s Best Companies
to Work For” – Study through :

Please enter the text as it is shown in the box below :