Hiring Intake Form

Company Name*

What is your company’s name?

Company Logo*

Accepted file types: jpg, jpeg, png, Max. file size: 1 MB.

Please upload your company logo. File size limit 1MB.

What industry is your company in?*

Select the applicable category

Company Contact Name*

First Last

(For internal use – this information will not be made publicly available)

Company Contact Title*

(For internal use – this information will not be made publicly available)

Company Contact Email*

(For internal use – this information will not be made publicly available)

Company Contact Phone*

(For internal use – this information will not be made publicly available)

Positions*

Enter a descriptive title of the positions that you are trying to fill (e.g. “stock clerk” rather then “clerk”)

How many of these specific positions are you looking to fill?*

Please enter a specific or approximate amount.

Are you hiring for this position in multiple locations?*

Yes
No

If you are hiring for this position in multiple locations, please enter each location where you are hiring this position for. Please use the following format for each line: [STREET ADDRESS]; [CITY]; [STATE]; [ZIPCODE]:*

For example, each location should be on a seperate line, written out as follows: 123 Main Street; Newark; NJ; 07102:

Position Location*

Street Address City State ZIP Code

What shifts are you hiring this position for? Check all that apply*

Daytime
Evening
Overnight
I don’t know

What are the job requirements for this position?*

No previous work experience required
Previous work experience required
No resume required
Resume required
Specific license or credential required

If there are specific license or credential requirements, please describe them:*

For instance: Commercial Drivers License, LPN Licensure, etc.

What are the wages for this position?*

Please list a specific hourly wage or range, or a salary (if applicable).

How should interested applicants get in touch with you or apply for this position? Please complete all that apply.*

Via Company Website
Via Email
Via Phone
In-person at the job location
Other

Enter Company Website*