New Job Request Form
Submit a new job today and we’ll help pair your business with a qualified shift worker.
Company Name
Date
Requestor’s First & Last Name
Requestor’s Phone
Requestor’s Email
Job‑site Contact
Name
Job Title
Phone
Email
Project Name
Job‑site Address
P.O. Number (if applicable)
Quantity & Title of Requested Talent
Job Details
Requested Job Start Date
Job Start Time
Estimated Length of Job*Estimated Length of Job*1 Year +6 – 12 Months3 – 6 Months1 – 3 Months2 – 4 WeeksTemp to Hire after 480 hrs
Estimated Hours Per Week*Estimated Hours Per Week*40 – No Overtime40 to 50 – Some Overtime40 to 60 – A lot of Overtime
Language Requirements *Language Requirements *No Preference (Spanish is OK)Spanish Speaking OnlyEnglish Speaking Only
Company Pay Period (Mon–Sun, etc.)
Will this job require any special PPE, CCIP, Davis Bacon or Badging?*
CCIP / OCIP / ROCIP Requirements (please attach insurance enrollment packet)Badging (please attach badging paperwork)Davis Bacon / Wage Determination (please include wage determination form)Any Special PPE (Unified Personnel provides employees with a standard issued hard hat, safety glasses, ear plugs, cut level 4 gloves, high visibility vests and shirts in most instances)None of the Above
Upload related files (multiple allowed, max 20 MB total)
Who will approve time sheets?*Who will approve time sheets?*MeOnsite ContactBoth me and the Onsite ContactSomeone Else
Additional Timesheet Approver (Name)
Approver Email
Approver Phone
