| Name of Organization:* |
|
| Number of employees:* |
|
City/province where primary
work site is located:* |
|
Other work locations
(please list by city/province): |
|
Send quote to: |
| Contact Name:* |
|
| Position Title:* |
|
| Address 1:* |
|
| Address 2: |
|
| City:* |
|
| Province*: |
|
| Postal Code:* |
|
| Phone:* |
|
| FAX: |
|
| E-mail:* |
|
Please indicate which
of the following services
you would like included
in your quote:*
(check as many as apply) |
Wellness Seminars
Training Workshops
Manager Coaching
Substance Abuse Programs
Programs for Depression/Mental Health
Team Restoration/Intervention
Violence Prevention Programs
Critical Incident Response Services
Work-Life Programs
Life Coaching
Employee and Family Assistance Programs
other services (please list/describe):
|
|
OPTIONAL: Additional information about the Organization |
Industry/sector: |
government
health/social services
education
public/protective services
public utilities
telecommunications
transportation
financial services
computer/technical services
legal/accounting/engineering services
wholesale/retail/business sales
insurance/real estate
accommodation/food service
manufacturing
other
|
Employee groups include:
(check as many as apply) |
administrative support
data entry clerks
sales/marketing personnel
computer technicians
drivers/couriers
legal/financial professionals
health/home care workers
medical professionals
law enforcement officers
skilled trades people
machine operators
other
|
Organization is unionized? |
Yes
No
|
Comments: |
|
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