Please complete all fields marked required (*). Your Superior Staffing Representative will contact you shortly to follow up on your order request.

Company	*	Name of Person Requesting Employee	*
Work Location	*	Phone Number of Person Requesting Employee	*
E-Mail of Person Requesting Employee
Department Ordering	*	Department Using	*
Person to Report to	*	Person Directly Works for	*
Reason for need of Temporary *
Project		Maternity Leave
Sick/ Medical Leave		Vacation
Until Company Hires		Overload/ Backlog
Possible Temp to Permanent Hire		Direct Hire
Number of Temps Ordered	*
Work Hours for Temp	: * to  : * with  *  Hours For Lunch
Shift	1st 2nd 3rd
Overtime
Evenings & Weekends		Saturday Only
Evenings Only		Sunday Only
Anticipated Start Date	*	Approx Length of Assignment	*
Salary if Hired
Benefits to be Offered
Do you want to review resumes first?	Yes No	Do you want to interview the temporary?	Yes No
Job Description *