Job Orders

Client/Prospects Temp to Perm Job Order

Company Name *

Contact Name *

Company Address *

Company EIN# *

Email Address *

Phone Number *

Job Title *

Department requiring Staff *

Position Title *

Number of Positions *

Job Description/ Duties *

Location of work site? *

Start Date? *

Anticipated Duration of Temporary Role *

Less than 1 Month
1-3 Months
3-6 Months
6 Months

Relevant Certification *

Copy of Certification, Diploma, Degrees etc. *

Emailed Certificate, Diploma, Degree
Dropped off Certificate, Diploma, Degree
Mailed Certificate, Diploma, Degree
Don't have Certificate, Diploma, Degree

Work Experience *

Skills Competencies needed *

Language Preferences *

English
Spanish
Bilingual
Other

Benefits Description *

Hourly/Wage/Salary *

Per Hour
Weekly
Bi-Weekly
Per Annually

Hourly/Wages/Salary Amount *

Overtime Pay *

Yes
No

If yes (Explain) Rate *

Benefits Offered upon Permanent Hire *

Health Insurance
Paid Time Off
Retirement Plan
Other

Additional Notes *

Client Authorize Signature *

Date *

Agency Authorize Signature *

Date *