Partner Express Verification Form

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This form will be used by all non-DES partners to provide information about the businesses they are working with, but still needing to be verified in AJC. In order to prevent a lengthy verification process, the DES team will check this information prior to performing any verifications and automatically approve the employer.
The person completing this form confirms all information submitted is valid.

Email *

Employer Name *

Employer Contact Email Address *

Located? *

Where are you located?

New employer or reactivation *

Is this a new employer or a reactivation of an employer account?

New Employer

Reactivation

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