HERO Scorecard HERO Scorecard Benchmark Report Order Form Name(Required) First Last Company name(Required)Title at company(Required)Email address(Required) Please select which type of benchmark report you are interested in purchasing(Required) Custom benchmark report ($1500) Select completers benchmark report ($1500) Custom benchmark report optionsSelect a variable from each category below that you want to benchmark your organization against. Region(Required) South West Midwest Northeast Industry type(Required) High tech Tech – professional services Government Financial services Higher education Manufacturing Healthcare (hospitals and healthcare clinics) Organization size(Required) Employers with <100 employees Employers with 100-499 employees Employers with 500-999 employees Employers with 1,000-4,999 employees Employers with 5,000-19,999 employees Employers with 20,000+ employees Employers with <500 employees Employers with 500 – 4,999 employees Employers with 5,000+ employees Select completers benchmark report optionsList at least ten completers that you want to receive a benchmark report for. Add lines as needed for additional completers (maximum 25). Click here for a list of completers.Completers(Required)1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Payment informationTotal Defer payment Please send me an invoice Credit card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Δ
