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If you are not a current or former client, please fill out a
Client Information Form
before proceeding with your Work Order Request.
Email Address:
CLIENT INFORMATION:
Company Name:
Contact/Report to:
Company Address:
Phone #:
Ext.
Fax #:
Ext.
# of Temps Needed:
Duration of Assignment:
Days
Weeks
Months
Possibly Permanent
Reason for Temp:
REQUIREMENTS FOR TEMP:
Job Sector:
Choose A Job Sector
Accounting
Clerical
Commercial Lines P/C
Construction Defect
Financial Services
Health/Benefits
Human Resources
Legal
Life/Disability
Medical
Personal Lines P/C
Professional Liability (E/O, D/O)
Risk Management
Surety
Workers Compensation (Med Only)
Workers Compensation
Other
Job Title/Description:
Please include experience level and general overview of job duties.
Job Requirements:
Please include specific types of license(s), designation(s) or degree(s) required for the position.
Salary Range:
Please specify if amount is per Hour, Week, Month or Year.
Computer Software Applications:
Typing Ability:
Additional Instructions:
(888)528-8367 or (619)528-8434
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