Welcome!
*Order Requested By
*Assignment Start Date
*Number of Workers Needed
*Company Name
*Job Site Address
*Report To
*Job Site Phone
* Time
Mobile
*Job Description
PO Number
Special Qualifications
Employee Requested
Directions to Site
Cross Streets
Safety Equipment Needed
Safety - If Other
How Did You Hear About Gem State Staffing?
only required for first time orders
Customer Name
Code
Billing Address
Phone
Fax
Federal Tax ID
