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Gregg/Industrial Employees Information Request

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Gregg companies are committed to providing the best possible service to our customers and employees. Your comments will help us to continually improve and expand those services. Please take a moment to complete this form. All information will be treated as confidential and will not be disseminated outside the Gregg companies.

Note that all *starred items are required.

Company Information

*Company Name
*Address 1
Address 2
*City
*State
*Zip Code
*Phone
Fax
*Contact Name
Contact Title
Email
*Please choose the industry category that most closely describes your business.

Staffing Needs

*Do you use temporary or contract employees?	Yes	No
*If yes, number of employees each week:	1 to 5	6 to 10
*If yes, number of employees each week:	10 to 20	More than 20
Frequency:	Seasonal or As Needed
	Continuously
	In Lieu of Regular Employees
	Temp or Permanent Employee
What kinds of work do they do?	Office Clerical	Skilled Trades
	Engineering/Technical	Construction Trades
	Accounting/Financial	Manufacturing/Assembly
	Legal Services/Support	Distribution
	Food Service	General Labor
	Medical Services	Other:
Who is your current vendor?
Do you use more than one vendor?	Yes	No
Would you be interested in how Gregg could help you?	Yes	No
Please enter any questions or comments here:

When you are satisfied with your information, please click the submit button. You will be contacted by the nearest Gregg office shortly.