H-2A EMPLOYER PROFILE
Email address *
COMPANY LEGAL NAME *
Your answer
EMPLOYER STREET *
Your answer
EMPLOYER CITY *
Your answer
EMPLOYER STATE *
Your answer
EMPLOYER COUNTY
Your answer
EMPLOYER ZIP CODE *
Your answer
PRIMARY CONTACT FIRST NAME *
Your answer
PRIMARY CONTACT LAST NAME *
Your answer
PRIMARY CONTACT TITLE *
Your answer
PRIMARY CONTACT MOBILE *
Your answer
PRIMARY CONTACT OFFICE PHONE *
Your answer
PRIMARY CONTACT EMAIL *
Your answer
SECONDARY CONTACT FIRST NAME
Your answer
SECONDARY CONTACT LAST NAME
Your answer
SECONDARY CONTACT TITLE
Your answer
SECONDARY CONTACT MOBILE
Your answer
SECONDARY CONTACT OFFICE PHONE
Your answer
SECONDARY CONTACT EMAIL
Your answer
FEIN *
Your answer
STATE UNEMPLOYMENT # (if applicable)
Your answer
GROSS INCOME FROM PREVIOUS YEAR *
Your answer
NET INCOME FROM PREVIOUS YEAR *
Your answer
YEAR ESTABLISHED *
Your answer
LINE OF WORK (do you want a drop down for this?) *
Your answer
PLEASE DESCRIBE YOUR BUSINESS AND NEED FOR TEMPORARY WORKERS *
Your answer
IF YOU ARE A FARM LABOR CONTRACTOR, DO YOU HAVE A VALID FLC LICENSE? *
ARE YOU PART OF A COLLECTIVE BARGAINING AGREEMENT? *
DO YOU HAVE PAYROLL RECORDS FROM THE LAST TWO CALENDAR YEARS? (do you want this q on here for H-2A?) *
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