CLIENT REQUESTS FOR EMPLOYEES 
Please print this form and complete by hand OR 
download and fill it in as a text file. 
Please return to the address listed at the bottom of this form.

DATE OF CONTACT…………………………………………………………………

COMPANY NAME……………………………………………………………………

LOCATION……………………………………………………………………………

CONTACT NAME………………………………………………………………………

TELEPHONE NO:………………………………FAX…………………………………

ABN NUMBER…………..……………………………………………………………..

TYPE OF BUSINESS……CAT1 CAT2 CAT 3 (for Workcover purposes)

WORKCOVER NO:……………………...……………………………………………..

IS THIS A TEMPORARY OR PERMANENT PLACEMENT?………………………

WHAT SKILLS/EXPECTATIONS ARE REQUIRED?………………………………

…………………………………………………………………………………………

…………………………………………………………………………………………

ANY PREFERENCE FOR SOMEONE WORKED THERE BEFORE………………

DATE EMPLOYEE REQUIRED………………………………………………………

WORKING HOURS……………………………………………………………………

DURATION OF CONTRACT…………………………………………………………

WHO SHOULD THE EMPLOYEE REPORT TO…………………………………

WILL THERE BE ANY HEALTH & SAFETY INTRODUCTION…………………

DETAILS OF HOW TO GET TO COMPANY………………………………………

…………………………………………………………………………………………

PLEASE RETURN THIS FORM TO HILLS STAFF 
EMAIL ATTACHMENT: stevesmith5@bigpond.com.au
FAX: (08) 8391 5545
POST: PO Box 1489 Mt Barker SA 5251