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Fax Job Order Form
Please use a separate form for each job title.
Date:
Company Name:
Employer ID:
Address:
City: State: Zip:
Contact Name:
Second Contact Name:
E-Mail:
Telephone: FAX:
| Job Information | |||
|---|---|---|---|
| Position | Number of Jobs | ||
| Job Duties | |||
| Salary (Per Hour or Per Year) | Medical Benefits Yes or No | ||
| Choose One: Full-time Part-time | |||
| Hours of Work | Start: | End: | |
| Choose One: Permanent Temporary | |||
| Education Needed | |||
| Degree or Certificate (if required) | |||
| Are you willing to accept a trainee? Yes No | |||
| How many applicants do you wish to see? | |||
Fax this to a VESID District Offices Regional Marketing Representative
