ORDER FORM

Please place your order online:

COMPANY INFORMATION  
Company Name:
Company Billing Address
  
Address Line 1:
Address Line 2:

City:

Province:
Postal Code:
Company Report to Address
  
Address Line 1:
Address Line 2:

City:

Province:
Postal Code:
   
Company Phone:
Company Fax:

CONTACT INFORMATION		  
Contact Name:
Contact Email:
Contact Phone & Extension:
Quantity of personnel required:
Start Date:
(mm/dd/yyyy)
Start Time:
Length of Assignment:
Working Hours:
Report to Supervisor:

Job Description and
Skills Required:



Safety Equipment Required:
 

For new accounts, prior to filling your order the following items are required: Credit Application, worksite inspection/tour, and signed acceptance of our pricing and terms.

 
1750 Steeles Ave. W, Suite #219, Concord, Ontario L4K 2L7
Tel: (905) 761-0415 Fax: (905) 761-0413
Email: info@affordablepersonnel.com