Please take a moment to complete the Needs Assessment form below
General Information
Name:
Company:
Address:
City/State/Zip:
Phone:
Fax:
Email:
Position Information
Type of work: (Please be specific)
Average number of hours per week per employee in this position:
The 4 digit workers compensation code for position to be filled:
Estimated number of workers needed:
Total workforce number:
Current hourly pay range:
Benefits provided to current workforce
Number of paid vacation days?
Insurance benefits?
Needs Assessment Form
