Recruiting Department Request/Change Form1. Branch/Onsite Location(Required)BQGCHICSDCYDDECEFFEVAFTX - BLFTX - THGIBHSFHGPHGSHGIICSMATNASOWBPERSIESLMSMMSPRTRHTWPOTHER2. Requested By:(Required)3. Email Address(Required)4. Position Type(Required) Light Industrial Clerical5. Request Type(Required) New Listing Rate Change Description Change Remove Listing New Incentive (See Item #19) Remove Incentive (See Item #19)6. Request Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119207. Effective DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920(If different than Request Date)8. Client Name(Required)Please use full name.9. Position TitleAssemblyAssembly & Machine OperatorAssembly & MachiningAssembly & Paint LineAssembly & WarehouseAssembly OperatorBinderyCNC MachiningCNC OperatorCoils BrazerDie CastDigital Press OperatorElectronics AssemblerElectronics Assembler 2nd ShiftForklift & WarehouseForklift OperatorForklift, Fabrication & FinishingFront Desk AttendantGeneral LaborInjection PackagingInspector & PainterLead Test OperatorLoaders & PackersMachine OperatorMachine Operator & Die CastMail SortingMail SortingMaintenanceMaintenance TechnicianManufacturing & Machine OperatorManufacturing AssociateMaterial HandlerMaterial Handler - Box On DemandModel Shop Test DriverPackagingPackaging & SanitationPackerPress OperatorPress Operator & AssemblerPress Operator & BinderProcessorProductionProduction AssociateProduction AssociateProduction Team MemberProduction WorkerProduction, Assembly & Die CuttingPurchasing AssistantQuality ControlReprocessingShipping & PackagingShipping & ReceivingSkid Loader/SealerSpot WeldingTeam LeadTechnical WriterTool Crib AttendantTruck LoaderWarehouseWarehouse AssociateWelders, Polishers & WoodshopWelding, Stamping & ConveyanceWood ShopNOT LISTEDIf not listed please select "NOT LISTED" and fill out the next section.10. Position Title (If unlisted)Please enter the position title in the space above if not listed in the previous dropdown.11. No. of Orders (For this Position)(Required)Please enter the number of open orders for this client. Enter "0" if not applicable.12. Minimum Pay Rate13. Maximum Pay RateLeave blank if rate is flat.14. Job LocationClimate Controlled Facility? (NEW!!)YesNoOther15. Available Shifts First Second ThirdPlease select all that apply.16. Full-Time/Part-Time Full-Time Part-TimePlease select all that apply.17. Additional Information Mandatory Overtime Optional Overtime Mandatory Weekends Optional WeekendsPlease select all that apply.18. Incentives Available Referral Bonus Sign On Bonus Attendance Bonus OtherPlease check all that apply and provide detail below.NEW!! Selling Points (what will get applicants excited about this job?)19. Incentive Specifics/TermsPlease describe in detail.20. Notes/Special Circumstances21. Job DescriptionFor new orders/clients, please include job description, shift information, client benefits once hired full time, etc.22. Position Type(Required) Flex/Flex-to-Hire Temporary Only - No Full-Time Opportunity