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Candidate Referral Form



            Referral Date:                                        Referral Bonus Rate: $400.00

            Hiring Manager:                                       Hard-to-Fill Position Referral Rate: $1,000.00*


            HEPACO Employee Information:                          Candidate Information:

            Full Name:                                            Full Name:

            Phone #:                                              Phone #:

            Service Location:                                     Service Location:

            Employee ID:                                          Email Address:


            Check Position Applying for: Asterisk (*) Positions will receive Hard-to-Fill Position Referral Rate.
               Project Manager*         Supervisor*         Foreman*                 CDL Driver*
               Technicians              Administrator       Other:

            Relationship to Candidate:  Check all that apply.
               Worked Together          Friend              Relative                 Other:


                    The hiring of a referred employee must occur within 60 days of the initial referral date.
                    To be eligible for an award, all candidates must be submitted to the hiring manager and must include a Candidate
                   Referral Form or a copy of their resume along with your name and employee ID number.
                    The referring employee must agree to have his/her name used for introduction.
                    The first employee to refer a candidate will be the only referring employee eligible for payment.
                    Only candidates who meet the essential qualifications for the position will be considered.
                    All information regarding the hiring decision will remain strictly confidential.
                    The referring employee must still be employed by HEPACO during the hired candidate’s employment in order to
                   receive payment.
                    If your candidate is hired, you will receive 50% of the referral bonus payment after the referred employee works
                   90 days (minimum of 520 regular hours) and the remainder after the referred employee’s 1-year anniversary at
                   HEPACO (minimum of 2,000 regular hours).
                    Referral must be for a current opening for the service location.

            Referral Eligibility: All HEPACO employees are eligible for referral bonuses with the exception of Project Manager level and
            above with hiring authority over the referred candidates. Previous HEPACO employees will not be considered a referral
            candidate. See HEPACO referral policy for full rules.


            TO BE COMPLETED ONCE CANDIDATE IS OFFERED POSITION


                    Tentative Start Date                Employee Signature                Hiring Manager Signature


                                      Submit via Email to tas@hepaco.com or Fax 704.598.9788
                                                                                                   Updated 12/07/17
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