Illinois Works Job Order Request

Organization Information

Organization Name

Organization Contact Name

Organization Contact Email

Organization Contact Title

Organization Type

Contractor

Other

Organization Contact Phone Number

Phone

Trades

If other, please explain:

How many years has your company been in business?

Please select all that apply to your business:

Please select certified if you have been certified by the State of Illinois Commission on Equity and Inclusion (CEI) and hold an active certificate.

Signatory to Union(s)

Yes

Job Order Request

Position

Description

Job Site / City / Location

Zip Code

Construction Experience Preferred

No experience

Less than 1 year

1-3 years

Certifications

First Aid/ CPR

High School Diploma/GED

NCCR/NABTU/ICCB Certification/Certificate

OSHA Certification

Number of Available Positions

Expected Work Hours

Expected Starting Date

mm/dd/yyyy

Expected Salary

Travel Requirements

Please select the maximum distance to travel (miles)

100

Applications Due By Date

mm/dd/yyyy

Other Qualifications

Send me a copy of my responses