Welcome to the WOTC Employer Registration
Please enter your company information below.
After you have finished click the "Submit" button to proceed.
Mouse click or use the Tab key on the keyboard to move between fields.
Company Information
Fields with "
*
" are required
*
Company Name:
2nd Name Line:
*
Federal Employer ID Number (FEIN):
*
Mailing Address:
Address 2:
*
City:
*
State:
Oregon
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
North Carolina
North Dakota
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Wisconsin
West Virginia
Wyoming
American Samoa
Guam
Puerto Rico
Virgin Islands
*
Zip Code:
*
Contact Name - First
/
Initial
/
Last:
Title:
*
Phone Number:
-
-
x
Fax Number:
-
-
E-Mail Address:
Physical Address (if different from Mailing Address):
Address 2:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
North Carolina
North Dakota
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Wisconsin
West Virginia
Wyoming
American Samoa
Guam
Puerto Rico
Virgin Islands
Zip Code:
Will you be responsible for retrieving decisions available on this website?
Yes
No
User Name-Verify FEIN:
Password:
(Must be at least 8 characters max of 12)
(will show as "*")
Verify Password:
(will show as "*")
If you have questions/comments about this site please e-mail