Tompkins Workforce New York - Business Registration Form

Business Registration Form

All information submitted will be kept private. It will not be sold, rented or given to any other entity.
It is for the use of Tompkins Workforce New York exclusively.


All information in the gray area is required.
Company Name:
Company Address:
Company City:	State Zip
Contact Person:
Phone:	xxx-xxx-xxxx format
Fax:	xxx-xxx-xxxx format
Email:


1. Size of Company (including any OJT interns):
a) Under 50 employees b) 50-200 Employees c) Over 200 Employees
2. Start-up business? Yes No
3. Expanding business? Yes No
4. If yes to either #2 or #3, is the business located in an Empire Zone?Yes No
5. Minority or woman-owned business Yes No
6. Brief description of business products and/or services:



7.	Does your company currently recruit all or some of your new hires through the Department of Labor/One Stop Career Center? Yes No
	If not, are you willing to list job openings with the One Stop Career Center in the future? Yes No Only certain positions Need more information
8.	Is your company interested in receiving any of the following information/services? (check all that apply)
	Local Labor Market Information (e.g. prevailing wages, skills shortages, vacancy data, etc.)
	Information on Grants to Fund Training
	On-the-job Training Assistance
	Customized Training Assistance
	New Hires
	Employed worker skill upgrade
	Employed worker retention
	Other
9.	Please indicate your most pressing issues related to your workforce. Select up to five (5) of the most critical issues:
	Lack Human Resource staff or expertise
	Recruitment
	Retention
	New worker training
	Upgrade training
	Supervisor Training
	Workplace Literacy
	Personal Life Management Skills
	Workplace Behavior
	Safety & Health issues
	Insufficient technical skills
	Other
10.	If not mentioned above, what specific skills shortages are most impacting your business or organization's ability to maintain or grow it's profitability and/or success?