Fields in red are required.
COMPANY INFORMATION

Date:  
Company:  
Contact  name:  
Title:  
Address:  
Phone:  
Fax:  
E-Mail:  

   Bill To:
Company:  
Contact  name:  
Address:  
Phone:  
Fax:  

JOB DESCRIPTION

Temp Position   Temp to Hire   Perm Position
If Temp-to-Hire or Permanent, Salary Range:

Job Title:  
# of employees needed:

Duties &   
Responsibilities:  
Required Skills:  

ASSIGNMENT DETAILS

Address of Work Site. If Different from Company Address:

Report to:
Department:
Start Date:  
Start Time:  
Work Hours:  
Length of Assignment:  
Approprate Attire:  
If other:  

  Comments:

 
"Thank you for considering RESOURCE Staffing"