Senior Employment Resources (SER)
A non-profit 501(c)(3) organization

Job Order Form

 4201 John Marr Drive, Suite 236
Annandale, VA 22003-3204
Phone: 703-750-1936
FAX: 703-750-0269
E-mail: office@seniorjobs.org
Date:
 Job Code (Office Use)
Company:
Mailing Address:
Email:
Phone:
 FAX:
Contact Person:
 Title:
How did you learn about SER?
May Client call you directly?
 Type of Business:
JOB TITLE: JOB LOCATION:
JOB DESCRIPTION (list duties and responsibilities):
Typing (WPM):
 Computer:
 Word Processing:
Drive?
 Own car needed?
 Compensation for car?
Other qualities desired:
Full-Time?
 Part-Time?
 Evenings?
 Weekends?
 Hours?
Salary Range:  $                 per Benefits (health/hospitalization, vacation, etc)

We agree to the following:  In the event we hire a full-time or part-time person referred by SER, we shall pay SER a Placement Fee equivalent to two weeks of the referral's salary.  We shall pay 10% of the total salary for a temporary person.  The minimum Placement Fee is $100.00.  All fees are payable within 30 days of the referral commencing work.  It is understood that SER will take collection action if payment is not received within 30 days.

Authorized Signature  ______________________________________

Please Print Name  ________________________________________