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Contract Employee Request

Please complete the following form to begin the search for a contract employee(freelancer) with automation, process control, or instrumentation experience. This information will be used to help our recruiters find the best candidates, and initiate The Employer of Record™ relationship. Please note: The information provided on this form will be used to generate legal documents including payroll and invoicing reports. Please confirm that all information is correct.
* Company Name:
* Contact Name:
* Address:
* City:
* State:
* Zip:
* Contact Email:
* Phone Number:
* Fax Number:
* Contract Employee Job Title:
* Job Description:
* Hourly Bill Rate:
* Anticipated Start Date:
* Anticipated End Date:
* Job Location: (City, State)
* How did you hear about us?
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