Alaska Employment Group Employee Request

Fields marked with * are required.

Company Name

Contact Person*

Street Address

City

States

Zip Code

Office Phone

Cell Phone

Fax Number

E-mail Address*

Job Title (for employee requested)

Total Employees Needed

Projected Start Date

Projected Length of Assignment (hours, days, weeks and/or months, etc.)

Location of Assignment (city, state, building, etc.)

Hourly Pay Range

Employee Duties and/or Skill Sets Requested

Any Special Certification, Education or Background Required

Will you need this person(s) to complete a background check?

Yes No

Will you need this person(s) to complete a drug test prior to starting?

Yes No

Do you have a written job description for this position? After submitting this form you will be redirected to Step 2 where you can provide us with additional information.*

Yes No

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