Employee ReferralTo be eligible for the employee referral bonus, staff should complete the following candidate referral form.Referring staff* First Last Name of candidate* First Last Candidate's address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Candidate's Phone*Candidate's Position*Please be sure that you fill in all the spaces above and press submit. Please note the referral form must be received before the candidate is hired. If the individual, you refer is hired and remains at the agency for at least three months you will receive the bonus in the amount of $250.00. You must also be actively employed at that timeCommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.