Rooftop Registration Form

Multiple Rooftop Registration Form

Payment of the $125 registration fee per dealership is required at time of registration. If you are unable to submit a credit card payment, please contact MGrosso@BestCompaniesGroup.com or 717-323-5278 before filling out the form below.

Before completing the registration form on the following page, Best Companies Group (BCG) needs you to agree and commit to the following statements. The form will not submit until all fields are filled out completely and accurately. You may enter up to five dealerships through this form. If you are entering multiple dealerships, there will be one transaction at the end of this form that totals the registration fees.

We will pay the required $125 registration fee to register for this program for each dealership rooftop. You must agree to this statement.

I have authorization from the executive(s) to enter these dealerships into the program. You must agree to this statement.

Each dealership I am registering meets the Eligibility criteria. You must agree to this statement.

Each dealership must complete BCG's two part survey process including the Employer Benefits & Policies Questionnaire (EQ) and the Employee Engagement & Satisfaction Survey (EESS) according to the Timeline. You must agree to this statement.

Each dealership must receive a minimum number of responses on the EESS to ensure our data is credible. If not enough responses are received, our ability to be considered for the list or to receive a statistically valid Employee Feedback Report may be impacted. You must agree to this statement.

We understand that we are responsible for paying the non-refundable registration fee and for any other additional services ordered (customization, translation fees, additional reporting, etc). If we withdraw after March 29, 2019, we will incur an additional $250 withdrawal fee to remove our dealership from the process. You must agree to this statement.

By entering my name below, I agree and commit to all of the above statements and confirm that I am authorized by the executive(s) of these dealerships. You must agree to this statement.

First Name*

First name needed.

Last Name*

Last name needed.

Title*

Title needed.

Email *

Valid email needed.

Phone*

Valid phone needed.

Phone Extension

Invalid

Dealership Group Tell us about your dealership group. Please list the HQ or primary location for your operations in the United States.

Dealership Group Name*

Response required.

Corporation Name of the Dealership Group

Response required.

FEIN/Business Number

Valid response required.

Mailing Address

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

County*

Response required.

ZIP Code*

Response required.

Website*

Valid response required.

Twitter Handle

Response required.

Is this the dealership's corporate address?*

Response required.

If no, please fill out below.

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

ZIP Code*

Response required.

Contact Information for All Locations Tell us about your people.

Primary Contact The Primary Contact will be the main contact for questions throughout the entire process and the recipient of all communications (via emails, phone, website and letters), employee surveys for distribution, feedback reports, etc. for all dealerships.

Salutation*

Response required.

First Name*

Response required.

Last Name*

Response required.

Title*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email *

Valid response required.

Confirm Email *

Valid response required.

Same as Organization Mailing Address Invalid Input

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

ZIP Code*

Response required.

Is this contact an employee of the company*

Response required.

Marketing/PR Contact The Marketing/PR Contact will handle any marketing and/or public relations questions for your dealership.

Salutation*

Response required.

First Name*

Response required.

Last Name*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email*

Valid response required.

IT Contact The IT Contact will be the contact for any technical systems questions regarding online surveys - for all employer questionnaires and online surveys for employees - regarding filtering, spam content, white-listing, etc.

Salutation*

Response required.

First Name*

Response required.

Last Name*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email*

Valid response required.

Human Resources Contact Human Resources Contact will handle any human resources related questions for your dealership.

Salutation*

Response required.

First Name*

Response required.

Last Name*

Response required.

Title*

Response required.

Phone*

Valid response required.

Phone Extension

Invalid Input

Email*

Valid response required.

Additional Questions

How did you hear about the program?*

Please select.

If Other*

Response required.

Are you interested in customizing your employee survey?

As part of the survey design process your organization has the option (for a fee) to customize the employee survey to include changing job roles/department selections, adding a location question, surveying all or additional employees and adding additional questions. If selected, you will be contacted by a survey specialist to learn more about these options.

Please select.

Dealership (Rooftop) One

Dealership/Rooftop One*

Response required.

Dealership Name*

Response required.

Legal Name of the Dealership*

Response required.

Did you participate last year?*

Invalid Input

What name did this dealership participate under last year?*

Response required.

FEIN/Business Number*

Valid response required.

Dealership Street Address*

Invalid Input

Address Line 2

Invalid Input

City*

Invalid Input

State*

Invalid Input

Zip Code*

Invalid Input

Website*

Valid response required.

Contact Information Tell us about your people.

General Manager at this Dealership

Salutation*

Invalid Input

First Name*

Invalid Input

Last Name*

Invalid Input

Title*

Invalid Input

Phone*

Invalid Input

Phone Extension*

Invalid Input

Email*

Invalid Input

You must have a total of at least 25 employees to continue.

Number of Employees Tell us how many employees you have working at this location.

If you employ more than 250 people, we will survey a random sample of your employees. Please enter the total number of employees (See Eligibility) working at this dealership. Please do not include temporary, seasonal or per diem employees, PRN, 1099 employees/independent contractors, volunteers, interns, outside consultants or staffing employees placed by other organizations. (See Eligibility)

Full-time Employees*

Valid numbers needed.

Part-time Employees*

Valid numbers needed.

Total Employees*

Valid numbers needed.

Participation Fees

Your level of participation depends on how many employees you have at your dealership and whether you choose the online or the paper employee survey process. See Online vs. Paper for more information. Please see the chart below to determine the survey selection, as well as the fees regarding dealership size and survey method if applicable. You will pay online at the end of this form.

While we recommend online surveys in most cases, sometimes paper is a better option. If more than 30% of your employees do not have their own email address, please select "paper" below.

* Participation Fees: Each dealership (rooftop) must pay a $125 non-refundable registration fee (which will be collected on the next page). For paper surveys, the primary contact will be invoiced separately by Best Companies Group according to the size of the dealership. Please note that the paper fees are in addition to the $125 registration fee.

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Participation Fee*	Paper Fee*
25 – 99	All	$125	$435
100 – 199	All	$125	$565
200 +	Up to 250**	$125	$655
Fees are non-refundable. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing.

Please select.

Number of eligible employees as indicated above.*

Response required.

Number of eligible employees as indicated above.*

Response required.

Survey Additional Employees? For employee populations over 250 we survey a random selection or, would you like to survey additional employees?

Response required.

Additional Information Tell us about your survey needs.

We offer employee surveys in a variety of languages. Additional languages are available at $215 per survey translation. If you need alternate language surveys, please select the languages below, and we will contact you to confirm your selections. Selecting "YES" above will add $215 to your cart per language. Payment will be required at the end of the form.

Does your dealership need alternate language surveys?

Response required.

Spanish – Latin American - 215.00 USD

Spanish – European - 215.00 USD

Portuguese - 215.00 USD

French – Canadian - 215.00 USD

French – Creole - 215.00 USD

French – Parisian - 215.00 USD

Chinese - 215.00 USD

Japanese - 215.00 USD

Other Language - 215.00 USD

Please select.

Language Selector Other*

Please name.

Employee Feedback Report Fees (optional)

Employee Feedback Report - A Management Tool

Purchase your Employee Feedback Report NOW and SAVE 10% off the price.* This report details the results of your dealership's specific survey results to each of the 78 survey questions. The report also includes benchmarking as well as the employee comments transcribed exactly as submitted by employees. Similar reports can cost thousands of dollars if initiated independently.

*Discount expires March 29, 2019

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Regular Pricing*	Pre-survey Pricing (discount)*	Savings
25 – 99	All	$880	$790	Save $90
100 – 199	All	$990	$890	Save $100
200 +	Up to 250	$1,080	$970	Save $110
Fees are non-refundable. After March 29, 2019 the reports go back to regular pricing. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing at 717-323-5278.

Would you like to purchase your Employee Feedback Report?

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Dealership (Rooftop) Two

Dealership/Rooftop Two*

Response required.

Dealership Name*

Response required.

Legal Name of the Dealership*

Response required.

Did you participate last year?*

Invalid Input

What name did this dealership participate under last year?*

Response required.

FEIN/Business Number*

Valid response required.

Dealership Street Address*

Invalid Input

Address Line 2

Invalid Input

City*

Invalid Input

State*

Invalid Input

Zip Code*

Invalid Input

Website*

Valid response required.

Contact Information Tell us about your people.

General Manager at this Dealership

Salutation*

Invalid Input

First Name*

Invalid Input

Last Name*

Invalid Input

Title*

Invalid Input

Phone*

Invalid Input

Phone Extension*

Invalid Input

Email*

Invalid Input

You must have a total of at least 25 employees to continue.

Number of Employees Tell us how many employees you have working at this location.

Full-time Employees*

Valid numbers needed.

Part-time Employees*

Valid numbers needed.

Total Employees*

Valid numbers needed.

Participation Fees

While we recommend online surveys in most cases, sometimes paper is a better option. If more than 30% of your employees do not have their own email address, please select "paper" below.

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Participation Fee*	Paper Fee*
25 – 99	All	$125	$435
100 – 199	All	$125	$565
200 +	Up to 250**	$125	$655
Fees are non-refundable. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing.

Please select.

Number of eligible employees as indicated above.*

Response required.

Number of eligible employees as indicated above.*

Response required.

Survey Additional Employees? For employee populations over 250 we survey a random selection or, would you like to survey additional employees?

Response required.

Additional Information Tell us about your survey needs.

Does your dealership need alternate language surveys?

Response required.

Spanish – Latin American - 215.00 USD

Spanish – European - 215.00 USD

Portuguese - 215.00 USD

French – Canadian - 215.00 USD

French – Creole - 215.00 USD

French – Parisian - 215.00 USD

Chinese - 215.00 USD

Japanese - 215.00 USD

Other Language - 215.00 USD

Please select.

Language Selector Other*

Please name.

Employee Feedback Report Fees (optional)

Employee Feedback Report - A Management Tool

*Discount expires March 29, 2019

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Regular Pricing*	Pre-survey Pricing (discount)*	Savings
25 – 99	All	$880	$790	Save $90
100 – 199	All	$990	$890	Save $100
200 +	Up to 250	$1,080	$970	Save $110
Fees are non-refundable. After March 29, 2019 the reports go back to regular pricing. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing at 717-323-5278.

Would you like to purchase your Employee Feedback Report?

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Dealership (Rooftop) Three

Dealership/Rooftop Three*

Response required.

Please click the green next button on the bottom of this page to continue on through the process.

Dealership Name

Response required.

Legal Name of the Dealership

Response required.

Did you participate last year?

Invalid Input

What name did this dealership participate under last year?

Response required.

FEIN/Business Number

Valid response required.

Dealership Street Address

Invalid Input

Address Line 2

Invalid Input

City

Invalid Input

State

Invalid Input

Zip Code

Invalid Input

Website

Valid response required.

Contact Information Tell us about your people.

General Manager at this Dealership

Salutation

Invalid Input

First Name

Invalid Input

Last Name

Invalid Input

Title

Invalid Input

Phone

Invalid Input

Phone Extension

Invalid Input

You must have a total of at least 25 employees to continue.

Number of Employees Tell us how many employees you have working at this location.

Full-time Employees

Valid numbers needed.

Part-time Employees

Valid numbers needed.

Total Employees

Valid numbers needed.

Participation Fees

While we recommend online surveys in most cases, sometimes paper is a better option. If more than 30% of your employees do not have their own email address, please select "paper" below.

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Participation Fee*	Paper Fee*
25 – 99	All	$125	$435
100 – 199	All	$125	$565
200 +	Up to 250**	$125	$655
Fees are non-refundable. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing.

Please select.

Number of eligible employees as indicated above.

Response required.

Number of eligible employees as indicated above.

Response required.

Survey Additional Employees? For employee populations over 250 we survey a random selection or, would you like to survey additional employees?

Response required.

Additional Information Tell us about your survey needs.

Does your dealership need alternate language surveys?

Response required.

Spanish – Latin American - 215.00 USD

Spanish – European - 215.00 USD

Portuguese - 215.00 USD

French – Canadian - 215.00 USD

French – Creole - 215.00 USD

French – Parisian - 215.00 USD

Chinese - 215.00 USD

Japanese - 215.00 USD

Other Language - 215.00 USD

Please select.

Language Selector Other

Please name.

Employee Feedback Report Fees (optional)

Employee Feedback Report - A Management Tool

*Discount expires March 29, 2019

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Regular Pricing*	Pre-survey Pricing (discount)*	Savings
25 – 99	All	$880	$790	Save $90
100 – 199	All	$990	$890	Save $100
200 +	Up to 250	$1,080	$970	Save $110
Fees are non-refundable. After March 29, 2019 the reports go back to regular pricing. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing at 717-323-5278.

Would you like to purchase your Employee Feedback Report?

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Dealership (Rooftop) Four

Dealership/Rooftop Four*

Response required.

Please click the green next button on the bottom of this page to continue on through the process.

Dealership Name

Response required.

Legal Name of the Dealership

Response required.

Did you participate last year?

Invalid Input

What name did this dealership participate under last year?

Response required.

FEIN/Business Number

Valid response required.

Dealership Street Address

Invalid Input

Address Line 2

Invalid Input

City

Invalid Input

State

Invalid Input

Zip Code

Invalid Input

Website

Valid response required.

Contact Information Tell us about your people.

General Manager at this Dealership

Salutation

Invalid Input

First Name

Invalid Input

Last Name

Invalid Input

Title

Invalid Input

Phone

Invalid Input

Phone Extension

Invalid Input

You must have a total of at least 25 employees to continue.

Number of Employees Tell us how many employees you have working at this location.

Full-time Employees

Valid numbers needed.

Part-time Employees

Valid numbers needed.

Total Employees

Valid numbers needed.

Participation Fees

While we recommend online surveys in most cases, sometimes paper is a better option. If more than 30% of your employees do not have their own email address, please select "paper" below.

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Participation Fee*	Paper Fee*
25 – 99	All	$125	$435
100 – 199	All	$125	$565
200 +	Up to 250**	$125	$655
Fees are non-refundable. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing.

Please select.

Number of eligible employees as indicated above.

Response required.

Number of eligible employees as indicated above.

Response required.

Survey Additional Employees? For employee populations over 250 we survey a random selection or, would you like to survey additional employees?

Response required.

Additional Information Tell us about your survey needs.

Does your dealership need alternate language surveys?

Response required.

Spanish – Latin American - 215.00 USD

Spanish – European - 215.00 USD

Portuguese - 215.00 USD

French – Canadian - 215.00 USD

French – Creole - 215.00 USD

French – Parisian - 215.00 USD

Chinese - 215.00 USD

Japanese - 215.00 USD

Other Language - 215.00 USD

Please select.

Language Selector Other

Please name.

Employee Feedback Report Fees (optional)

Employee Feedback Report - A Management Tool

*Discount expires March 29, 2019

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Regular Pricing*	Pre-survey Pricing (discount)*	Savings
25 – 99	All	$880	$790	Save $90
100 – 199	All	$990	$890	Save $100
200 +	Up to 250	$1,080	$970	Save $110
Fees are non-refundable. After March 29, 2019 the reports go back to regular pricing. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing at 717-323-5278.

Would you like to purchase your Employee Feedback Report?

Invalid Input

Dealership (Rooftop) Five

Dealership/Rooftop Five*

Response required.

Please click the green next button on the bottom of this page to continue on through the process.

Dealership Name

Response required.

Legal Name of the Dealership

Response required.

Did you participate last year?

Invalid Input

What name did this dealership participate under last year?

Response required.

FEIN/Business Number

Valid response required.

Dealership Street Address

Invalid Input

Address Line 2

Invalid Input

City

Invalid Input

State

Invalid Input

Zip Code

Invalid Input

Website

Valid response required.

Contact Information Tell us about your people.

General Manager at this Dealership

Salutation

Invalid Input

First Name

Invalid Input

Last Name

Invalid Input

Title

Invalid Input

Phone

Invalid Input

Phone Extension

Invalid Input

You must have a total of at least 25 employees to continue.

Number of Employees Tell us how many employees you have working at this location.

Full-time Employees

Valid numbers needed.

Part-time Employees

Valid numbers needed.

Total Employees

Valid numbers needed.

Participation Fees

While we recommend online surveys in most cases, sometimes paper is a better option. If more than 30% of your employees do not have their own email address, please select "paper" below.

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Participation Fee*	Paper Fee*
25 – 99	All	$125	$435
100 – 199	All	$125	$565
200 +	Up to 250**	$125	$655
Fees are non-refundable. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing.

Please select.

Number of eligible employees as indicated above.

Response required.

Number of eligible employees as indicated above.

Response required.

Survey Additional Employees? For employee populations over 250 we survey a random selection or, would you like to survey additional employees?

Response required.

Additional Information Tell us about your survey needs.

Does your dealership need alternate language surveys?

Response required.

Spanish – Latin American - 215.00 USD

Spanish – European - 215.00 USD

Portuguese - 215.00 USD

French – Canadian - 215.00 USD

French – Creole - 215.00 USD

French – Parisian - 215.00 USD

Chinese - 215.00 USD

Japanese - 215.00 USD

Other Language - 215.00 USD

Please select.

Language Selector Other

Please name.

Employee Feedback Report Fees (optional)

Employee Feedback Report - A Management Tool

*Discount expires March 29, 2019

Number of Eligible US Dealership Employees	Number of Eligible Employees Surveyed	Regular Pricing*	Pre-survey Pricing (discount)*	Savings
25 – 99	All	$880	$790	Save $90
100 – 199	All	$990	$890	Save $100
200 +	Up to 250	$1,080	$970	Save $110
Fees are non-refundable. After March 29, 2019 the reports go back to regular pricing. *Employees are randomly selected. Best Companies Group offers the option to survey more employees than the random sample calculated in the above chart, and/or include additional employees in the survey process who work in locations outside of the program area. Please contact Best Companies Group for details and pricing at 717-323-5278.

Would you like to purchase your Employee Feedback Report?

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Submit Your Registration You're almost done! (All fees are non refundable)

If the form does not submit, please review your information throughout the form to see what is missing or what needs corrected.

Same as Organization Mailing Address Invalid Input

Total Fee

$0.00 USD

Payment Options

Billing Address

Street Address*

Response required.

Address Line 2

Invalid Input

City*

Response required.

State*

Response required.

ZIP / Postal Code*

Response required.

Billing Contact

First Name*

First name needed.

Last Name*

Last name needed.

Phone*

Valid phone needed.

Phone Extension

Invalid

Email for credit card receipt, if applicable*

Valid email needed.

Fax

Valid phone needed.

Credit Card Information If applicable

Credit Card Number

Invalid Input

Card Security Code (CSC)

Invalid Input

Card Expiry Month

Invalid Input

Card Expiry Year

Invalid Input

Prove that you're human*

Response required.

If the form does not proceed to the next page, please review your information throughout the form to see what is missing or what needs corrected.

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