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     Please enter as much information as you can for the position you wish to fill.  An account representative will contact you within 2 hours if your order is received during normal business hours.  If we receive your order after hours, we will contact you the next business day.

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General Information

Job Title:


Position Type:



Salary Type:

Hourly     Annual

Salary Amount:

 Min: 
Max: 

How many people do you need for this position?


Hours Per Week:
(Hourly Positions)


Anticipated Start Date:


Assignment Duration:
(Temporary Positions)

Detailed Position Information
Job Description:

Typical Tasks:
(Enter up to 3)


Essential Skills:
(Enter up to 3)


Describe any special working conditions:


Is this a new position?


  Yes    No


Describe the last person to fill the job (if existing position):

What did you like most?
What did you like least?
Interview Information
Interview Required?   Yes    No
Name of Interviewer:
Number of Interviews:
Contact Information
Contact Name:
Phone Number:

Email Address:


When can we call you?

Company Information

Company Name:

Billing Address:
Worksite Address:

Same as Billing Address

Type of Business:
Years in Business:
Number of Locations:
Number of Employees:

Who are your Competitors?
(For recruitment purposes)

1.
2.
3.

Company Benefits:

Medical Dental Vision
401K    Life Insurance
Profit Sharing

Other Benefits:



          






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