Senior Employment Resources — Employer Online Job Order Form

Senior Employment Resources (SER)
4201 John Marr Drive, Suite 236
Annandale, VA 22003-3204

Phone: 703-750-1936
Fax: 703-750-0269
E-mail: office@seniorjobs.org

On-Line Job Order Form

1. Complete this form online
2. Then press the "Agree" button to agree to the contract terms
3. And press the "Submit" button to submit the job order to Senior Employment Resources


Date:
Company:
Mail Address:
Contact Person:
Name:
Title:
Phone:
FAX:
Email Address:
May client call you directly?
How did you learn about SER?
Job Description:
Job title:
Type of business:
Job location (city):
Job description/duties:
Skill Requirements:
Typing (wpm):
Computer skills
Word processing:
Driver's license:
Own car required?
Compensation for use of personal car?
Other qualities and skills desired:
Work Schedule:
Full time or part time?
Nights?
Weekends?
Work hours:
Compensation:
Salary range ( $ per ______ ):
Fringe benefits:
Additional Instructions / Comments:
Other comments:
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.
	Agree to terms Do not agree to terms
Signed:

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Senior Employment Resources (SER)
4201 John Marr Drive, Suite 236
Annandale, VA 22003-3204