Xcelent Staffing Request Form

Staffing Request Form for Employers

xaveria36@xcelentstaffingllcwebsite.com or (478)219-7458
Please complete this form and your Staffing Coordinator will contact you within 24 business hours to confirm your need.
Name:

First NameLast Name
Email:
example@example.com
Phone Number:
Please enter the best number to reach you.Format: (000) 000-0000.
Management Company:
Position needed
Contact Name:
Skill level requested
Site Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email to Send Invoices To:
Invoice Recipient Name:
Other Invoicing Instructions:
On-site Contact Person:
Contact's Phone Number:
Please provide us with on-site contact person's best phone number to reach them.Format: (000) 000-0000.
Available for Texts?
Additional Contact Info & Arrival Instructions:
Where & who to should our team member report when they arrive at your community? List any specific directions, for example, "report to Maintenance Shop located on left side of Leasing Office".
Position needed
Skills required
Are Hand Tools or PPE Required?
Additional Details about your Request?
Number of workers requested
Workdays
Meal/break arrangements
Primary duties
Tools/PPE details and who supplies them
Timesheet approver name
Timesheet approver email
example@example.com
Rate status
Client hourly bill rate
Quote/agreement reference
Interested in Direct Hire?
Start Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Start Time:

Hour Minutes

AM/PM Option
End Time:

Hour Minutes

AM/PM Option
Assignment End Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearUnsure of end date? You can auto-renew your assignment
Assignment and Billing Information

Cancellation requires 24 hours' notice Monday through Thursday and 48 hours' notice Friday through Sunday. Invoicing is issued weekly and is due upon receipt. The workweek for payroll and invoicing runs Sunday through Saturday. Hours worked must be recorded in full. Overtime for client billing is 1.5 times the applicable bill rate for hours worked over 40 in a workweek. On-call coverage is billed at $50 per weekday and $100 per weekend day only when separately agreed in writing. Returned checks are subject to a $50 fee. Any conversion, placement, or related fees must have their amount and terms separately agreed in writing. Any rate change must be confirmed in writing by Xcelent Staffing.
Signature:

Please use mouse or touch pad to sign. By signing this, I am stating I understand and agree to the terms and rates as explained and have authority to enter into a legal agreement.
Date Signed:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Acknowledgment
Should be Empty:

Staffing Request Form for Employers

Please complete this form and your Staffing Coordinator will contact you within 24 business hours to confirm your need.