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STAFFING ASSISTANCE REQUEST   Information or Order Request   Use the form below to submit a job order, contact one of our specialize account managers, or to obtain additional information on our company.   Date: Select your industry: Restaurant Hospitality Retail Customer Number: Name: Title: Company: Street Address: City: State: <-- Choose --> Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Zipcode: Email: Telephone: Best time to be reached: (please specify zone) Please indicate if your are already working with one of our Account Staffing Specialist: Which HR Solution do you prefer: Resume Search Ad Management & Applicant Review Resume Generation Talent Screening Talent Connection File Complete Outsourcing Solution Retained Searches Background Checks Reference Checks Performance Testing Undetermined Comments/Opening Info:

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