Online Job Order Sheet – Boise 8/16/2016 Return

*Order Requested By

*Assignment Start Date

*Number of Workers Needed

Order Information

*Company Name

*Job Site Address

*Report To

*Job Site Phone

* Time


*Job Description

PO Number

Special Qualifications

Employee Requested

Directions to Site

Cross Streets

Safety Equipment Needed

Hard HatBootsGlovesBack BraceSafety GlassesSafety VestFlagging PaddleHearing ProtectionOther

Safety - If Other

How Did You Hear About Gem State Staffing?

MailerWord of MouthNewspaperSales CallYellow PagesAdvertisingGoogle

New Customer Information

only required for first time orders

Customer Name


Billing Address



Federal Tax ID