Staffing: Client Intake Form
Business Name
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your industry?
Do you require your staffing to be incorporated?
Yes
No
Do you require them to have their own WCB?
Yes
No
Do you require them to be a GST registrant?
Yes
No
List all tickets that you require them to have:
When is the position starting? Select all that apply.
Now
1-2 weeks
2- 3 weeks
4 or more weeks
Number of positions available
Type of service Select all that apply
Temporary or contact hire
Temporary to permanent hire
Direct Hire
Payroll Service
Safety Training
Other
If Other, describe below:
Desired Geographical Area:
What shifts are available?
Provide any additional details below:
Signature
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: