Name of your firm:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
How Long in Business?
Telephone Number:
Website:
Your Firm's Email Address

Your Name:
Email Address You Can Be Reached At
Position with firm:
Industry or Professional Associations
to which your firm belongs

What type(s) of employees does your firm recruit?
Contract (temporary) Direct (captive) Both

Please indicate which type(s) of job openings you would like to advertise in our publication(s):
Contract (temporary) Direct (captive) Both

Where would the individuals you recruit from those ads be working?:
In your facility In your client's facility Both

Who would be supervising the day-to-day work of those recruited?
Your company Your client company

Is there any fee to apply for, or accept, positions you would be advertising?
Yes No

If yes, explain:

Does your company manufacture or market a product that is marketed to the public or to businesses?
Yes No

If yes, explain:

Is your firm a division, subsidiary, or in any manner affiliated with a parent company?
Yes No

If the answer to the above question is yes, please answer the following questions. Otherwise, click the button to submit your questionnaire for review.

The name of your parent company

Was your firm formed primarily for the purpose of providing contract employees to your parent company?
Yes No

Indicate which of the following your firm shares with your parent company:
Office Space Telephone Fax Staff Equipment Payroll Facilities Nothing

Do you place contract personnel with your parent company?
Yes No

Do you place contract personnel with firms other than your parent company?
Yes No

If so, are those other companies, in any manner, affiliated with your firm or your parent company?
Yes No

Approximately what percentage of the total number of contract personnel that you place work for your parent company?

Does any other contract firm supply contract personnel to your parent company?
Yes No

If so, what are the names of three of those contract firms?
Firm: Location:
Firm: Location:
Firm: Location:

Are contract employees that you place with your parent company treated any differently than those placed by other contract firms?
Yes No

If your contract employees are treated any differently, please explain the differences:


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