Employer Services

Employer Services Registration

Please fill out form completely.

All items with an * are required.

If you have any questions concerning this form, contact KMM using the contact page.
How did you hear of this program being offered by KMM?:*
I was referred by   
Website   
Radio
Newspaper   
KMM Newsletter
My Employer
KMM email blast
Social Media
Other   
My Contact Information
First name:*
Last name:*
Address:*
City:*
State:*
Zip code:*
Phone:*
Email:*
Survey Questions
How many employees work at this site?:*
What effect does traffic congestion have on your company? (Check all that apply.)
No effect
Employee tardiness
Difficult to recruit employees
Shipment delays
Difficult to park
Other   
Approximately, how many employees:
 Drive alone to work
 Carpool to work
 Vanpool to work
 Bike to work
 Walk to work
 Take a bus to work
 Take a train to work
 Are dropped off
Not sure
Please check each program that your company offers to employees:
Preferred parking
Rideshare matching
Commute information
Emergency ride home
Bike lockers
Bike racks
Showers
Financial support for carpools/vanpools
Transit passes
Transit subsidies
Company shuttles
We do not offer commuter benefit programs
Other   
Does your company offer: (Check all that apply.)
Teleworking
Compressed work week
Flexible work schedules
Not sure
Need More Information?
Need more information?
Please send me an Employer Services brochure
Contact me
Comments
Comments?