Workplace Financial Wellness Services Directory - Submission Form
If you would like to be included in the Workplace Financial Wellness Services Directory ("Directory"), please complete this form. By submitting this form, you are certifying that the information provided is true and accurate to your knowledge at the time of submission. Please note that CSD and Prosperity Now ("Directory Administrators") do not endorse, sponsor or promote any of the products or services offered by providers in this Directory. The Directory Administrators also reserve the right to exclude any services that submit an application or remove services included in the Directory. If you have any questions about the Directory or submission form, email Santiago Sueiro at ssueiro@prosperitynow.org.
Organization Information
Your organization's name *
Your answer
Your organization's website *
Your answer
What sector is your organization in? *
Contact for Directory Administrators
Please provide a long-term point of contact for future communication with the Directory administrators. You may provide a general inquiry line or customer service contact instead of a named person. Please put a generic name like "general inquiry line" or "customer service" for the name. You must also provide either a phone or email contact.
Contact Name for Directory Administrators *
Your answer
Contact Phone for Directory Administrators *
If you do not have a phone number for this contact, please type "N/A" here.
Your answer
Contact Email for Directory Administrators *
If you do not have an email for this contact, please type "N/A" here.
Your answer
Workplace Financial Wellness Services
What workplace financial wellness services does your organization offer? *
Required
If you selected, "Other" in the previous question, please describe your other workplace financial wellness services.
500 character maximum
Your answer
Please provide a short description about your workplace financial wellness service(s). *
1000 character maximum.
Your answer
What year did you start offering your service to employers? *
Your answer
What is your geographical service region? (Check all that apply) *
Required
If you would like to specify your geographical service region, please do so here.
500 character maximum
Your answer
Are your workplace financial wellness services available directly to employers without another vendor's involvement? *
This means your financial wellness services are available to employers without taking up any other service as a prerequisite (i.e. not through retirement or an insurance plan administrator or EAP).
If you responded "no" to the previous question, please describe. If not, write "N/A." *
1000 character maximum
Your answer
Please specify the pricing option(s) you offer for the services you provide (Check all the apply). *
Required
What type of employer do you serve? *
Do you provide services for non-English speaking employees? *
If you responded "yes" to the previous question, please describe. If not, write "N/A." *
500 character maximum
Your answer
Are you rated by the Better Business Bureau? If yes, please specify your rating. If not, write "N/A. " *
Your answer
Has your organization been penalized for non-compliance with state, local or federal rules and regulations? If yes, please describe. If not, write "N/A. " *
Your answer
Contact for Customer Inquiries
Please provide a contact for communication with potential customers. You may provide a general inquiry line or customer service contact instead of a named person. Please put a generic name like "general inquiry line" or "customer service" for the name. You must also provide either a phone or email contact.
Contact Name for Customers *
Your answer
Contact Phone Number for Customers *
If you do not have a phone number for this contact, please type "N/A" here.
Your answer
Contact Email for Customers *
If you do not have an email for this contact, please type "N/A" here.
Your answer
Is anything else you would like to share or that you would like to clarify in your answers? If so, please describe.
Your answer
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