Employer Qualifying Profile

Employer Contact Info
*Company Name
*Mailing Address
*Street
*City
*State *Zip
*Supervisor/Manager
*First Name
*Last Name
*Tax ID
*Telephone
Fax
*Email
Website ex. http://www.ccusa.com
*Do you have an online application?

If so, what is the web address?
ex. http://www.applications.ccusa.com
*How did you hear about CCUSA?
Other

Employment Details
*Dates of Employment
*First day of work click here to pick the date
*Last day of work click here to pick the date   clear dates
*Are these Start and End dates flexible?
*Desired number of international staff
*Jobs offered

(List positions and wages)
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*Frequency of pay  
*Average hours / week

Housing
*Is employee housing available?
*Approximate cost of housing (if housing is available)
*Deposit Amount (if housing is available)
*Type of housing   (if housing is available)

Additinal Information
Additional Employer Comments Characters Remaining