New Employer Advantage Program Form Company Name(Required)Company Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of Employees(Required)How many locations does your business have?(Required)Please select one.12345Please list your company's days & hours of operation(Required)Primary Contact Representative (Liaison)(Required) First Last Phone(Required)Email(Required) Preferred method of contact:(Required)Please select one.PhoneEmailLocation 2Location #2 Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name for Location #2(Required) First Last Phone for contact at Location #2(Required)Email for contact at Location #2(Required) Preferred method of contact for individual at Location #2:(Required)Please select one.PhoneEmailLocation 3Location #3 Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name for Location #3(Required) First Last Phone for contact at Location #3(Required)Email for contact at Location #3(Required) Preferred method of contact for individual at Location #3:(Required)Please select one.PhoneEmailLocation 4Location #4 Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name for Location #4(Required) First Last Phone for contact at Location #4(Required)Email for contact at Location #4(Required) Preferred method of contact for individual at Location #4:(Required)Please select one.PhoneEmailLocation 5Location #5 Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name for Location #5(Required) First Last Phone for contact at Location #5(Required)Email for contact at Location #5(Required) Preferred method of contact for individual at Location #5:(Required)Please select one.PhoneEmailPAYROLL INFORMATIONFrequency(Required)Please select one.WeeklyBi-WeeklyMonthlySemi-MonthlyOtherYou selected "other." Please explain.(Required)Is Direct Deposit Available?(Required)Please select one.YesNoHow do you share company news and information to your employees?(Required)Please select all that apply. Emails Company newsletter (physical or electronic) Staff meetings (virtual or in-person) Employee intranet site Collaboration tools (like Slack) Other (please list below) You selected "other" above. Please share the other ways you communicate with your employees.(Required)BENEFIT COMMUNICATIONSDo you have a new employee orientation/welcome packet?(Required)Please select one.YesNoDo you conduct benefit enrollment sessions?(Required)Please select one.YesNoYou selected "Yes" above. Please tell us when the benefits enrollment sessions take place.(Required)Do you have periodic staff meetings?(Required)Please select one.YesNoCan a representative from MCCU attend at least one of these meetings (per location, if applicable) to discuss the Employer Advantage Partnership & its benefits to your employees?(Required)Please select one.YesNoADDITIONAL MEANS TO DISBURSE CREDIT UNION BENEFIT AND SERVICESWill you invite a representative of MCCU to:Please check any that apply. Visit at least once a quarter, or as agreed, and distribute information to your employees by means of either in a meeting/conference room, or in a public area (lunch/break room)? Distribute periodic credit union supplied materials to employees-electronically or through individual mailboxes? Are there any other means you would prefer to provide information about the Employer Advantage benefit to your employees?ADDITIONAL BENEFITSWould you be interested in learning more about group benefit programs such as:Please check all that apply. Lunch & Learns (free educational seminars during the lunch hour) Having a Metrum representative visit your company for one-on-one scheduled appointments with staff (office must be located within 60 miles of Centennial, CO) Post Custom Field
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