Request Your Staffing Needs Online
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Please fill out the following form (or download the requisition form by clicking the link below) with as much information about the position you require. We will process your request immediately, and will contact you per your specifications. Thank you for your business!

Company Name:
Address:
Phone #:
Fax #:
Client (your) name:
Client e-mail:
Report to:
Department:
Start date:
End date:
Start time:
End time:
Lunch:	30 min 45 min 60 min
Overtime:	Yes No Possible
Job Title:
Number of people needed
Job description/skills on file?
Job Description:
Pay rate per hour:
Dress code:	Professional Business Casual Casual
Dress code details:
Skills required:
Reason for request:	Termed Employee Medical leave Maternity leave Jury duty Vacation FMLA Work overload Project Other
Approval for order needed?
Name of Approving Supervisor:
Supervisor's email:

Thank you for your order! One of our professional staffing specialists will contact you shortly
with the status of your request. If you have any questions, please contact us at
702-876-0708 or email us at requisitions@milleniumstaff.com. Once again, thank you
for this opportunity to serve you...