ESS Support

Southern Company Generation Request Form

Contract Company Name

Southern Company Affiliate

Date

Project Manager

contractor's primary contact at Southern Company

Project Manager Email

Project Manager Phone

Reason for Screens

Select Plant

Special directions or add-on screens such as license or education verification:

This information should be the individual at your company who is authorized to receive your employer status and is authorized to place orders.

Contractor Company Contact First Name

Contractor Company Contact Last Name

Contractor Company Contact Title

Contractor Company Contact Email:

Contractor Company Contact Phone

Contract Company Contact Fax

Contractor Company Contact Tax ID

Contract Worker to be screened

(please use worker’s legal first and last name):

Contract Worker to be screened email

Additional contract workers to be screened

(one contract worker and email per line)

GHRR - Fort Myers, FL

9530 Marketplace Road Suite 301
Fort Myers, FL 33912

GHRR - Birmingham, AL

2700 Corporate Drive Suite 100
Birmingham, AL 35242

GHRR - Manchester, NH

49 Ashland Street
Manchester, NH 03104-5112

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