Great Place to Work™'s "Best Companies to Work For in Australia" Study 2010, as published in BRW

"Best Companies to Work For in Australia" Study 2010 Nomination Form

The fields in (*) are required:

ORGANISATION CONTACT INFORMATION:
Nomination Information:
Name of person submitting the nomination:
e-mail of person submitting the nomination:	(You will receive an auto-reply email upon submission of this form)
Organisation Name
Organisation Headquarters City
Organisation Headquarters State	- Select - NSW QLD VIC SA WA ACT NT TAS
Industry
Organisation Web Site
Primary Contact:
If selected to participate, will be the main contact for questions throughout the entire process and the recipient of all communications, distribution of employee surveys, coordination of management questionnaire completion, etc.
Primary Contact First Name
Primary Contact Last Name
Primary Contact Title
Primary Contact Telephone	format : 12-3456-8790
Primary Contact Extension
Fax Number	format : 12-3456-8790
Primary Contact e-mail
Primary Contact Street Address	No P.O. Boxes
City
State	- Select - NSW QLD VIC SA WA ACT NT TAS
Postal Code
ELIGIBILITY INFORMATION:
How many regular, full-time employees do you currently have working in Australia?	Numbers only
How many regular, part-time employees do you currently have working in Australia?	Numbers only
Comments on full-time/part-time employee numbers (optional)
What year was your organisation founded?	4 digits. Note: if this year is later than 2008, an additional series of questions will appear.

Month organisation founded	Please choose January February March April May June July August September October November December
If your organisation was founded after 2008, did it previously exist (e.g. under a different name, as part of a larger entity etc.)?	Yes    No      If further explanation is necessary, please explain below
Further explanation (optional):
If your organisation previously existed, are there current employees who currently work for the organisation that had also worked for the organisation in its previous existence?	Yes    No

ADDITIONAL INFORMATION
If your organisation is selected to participate, we offer three options: Option 1) 100% of your employees will take the web-based survey Option 2) Your employees will take either the paper survey or the web-based survey Option 3) 100% of your employees will take the paper-based survey ** An additional costs of $6. each applies to paper-based surveys. Please answer the following questions to determine which survey method your organisation will be eligible to use.
Do 100 % of your employees have internet access?	Yes    No
Do 100 % of your employees have an individual email address?	Yes    No
If you answered 'yes' to BOTH of the above two questions, you are eligible for options 1, 2 & 3. If you answered 'no' to EITHER of the above two questions, you are eligible for options 2 & 3.
How would you prefer to have your employees take the survey if your organisation is selected to participate? Please select one of the options below:
Your survey method:	Option 1: 100% web     Option 2: A mix of web and paper    Option 3: 100% paper       Note: if you select 'Option 2' here, an additional question will appear.

Approximately what percentage of your employees have both internet access AND email addresses and would take the web-based survey? (Please give as a Percent. For example 5% should be entered as '5')
Percentage of employees with web access and email address	% (Number only)

How did you hear about the Great Place to Work TM "Best Places to Work" List selection process?
After clicking on "Verify" below, your information will be checked (there will be error messages at the top of the form prompting you to fill in any fields you may have accidentally missed) and then you will see a summary of the information that you have provided for verification.
Click to verify your information:

Additional information

For additional details or questions, please contact:
Great Place to Work^® Institute Australia
P.O. Box 1288, Rozelle
NSW, 2039, Australia
Phone: 1 300 13 18 79
Fax : (61) 2 9475 009
Email : info@greatplacetowork.com.au

www.greatplacetowork.com.au

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