Meridian Outplacement Enrollment Form

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Overview

Meridian Enrollment

When we began our company, one of our goals was to simplify the outplacement process for both the Corporate Sponsors and the participants. Our experience has shown us that people tend to use, and therefore benefit from, services and tools that are easy to understand and activate. That is why we made the engagement process so straightforward. We have taken the inconvenience and the mystery out of the system so that everyone involved can get on with what needs to be done.

Option 1: Contact your Meridian Representative (Single or Group Enrollment)
Contact your Meridian Representative directly by phone or email to begin the process. If you do not have an assigned Meridian Representative, please contact our Coaching Center please contact Angie Tinnell by EMAIL or call 800-924-8865, ext. 101.

Option 2: Download a Meridian Enrollment Spreadsheet (Single or Group Enrollment)
This option utilizes a simple spreadsheet to capture the essential information Meridian needs to begin the outreach and enrollment process with your separated employees. This may be used for a single enrollment or a group of separated employees. Download the Meridian Enrollment Spreadsheet.

Option 3: Complete and submit the Meridian Online Enrollment form below (Single Enrollment)
Please use this form to submit your request to enroll an employee into Meridian’s outplacement services. After you have entered the information, click the Save Participant button at the bottom of the form to submit your enrollment request. A Meridian representative will be in touch with you within 1-business day to verify receipt. If your need is urgent or if you need to speak with Meridian, please contact Angie Tinnell by EMAIL or call 800-924-8865, ext. 101.

* Designates a Required Field to submit Enrollment Request

Employee First Name *

Employee Last Name *

Date Meridian may initiate contact *

Date of Separation Meeting *

Projected Last Date of Employment

Severance Status *

Signed-Enroll
Not Signed-Enroll
Not Signed-Outreach Only

Program Level *

See Program Options, if necessary, to select appropriate level

Information about Employee or
Separation Meeting that may be
helpful to Meridian for first contact

Employee E-mail (Personal)

Please enter a personal or work e-mail

Employee E-mail (Work)

Employee Home

At least 1 phone number must be entered

Employee Mobile

Employee Office

Enter only if we may call this number

Employee Address

Employee City

Employee State

Employee Zip

Most Recent Job Title

Salary Level

Age

Gender

Male
Female

Years with Company

Educational Level

Your Name *

Your Phone Number *

Your E-mail *

Company Name &*
Billing Information:
Contact, Address
Phone, E-mail