Illinois Staffing Association

HEADQUARTERS INFORMATION

Select the Membership Type:

First Name		Last Name
Title		Organization
Address
Address (cont)		Location
City		State, Zip
Phone		Fax
Email		URL

Staffing Specialties

General Industry, select all that apply:

	Clerical		Professional
	Medical		Legal
	Industrial		Technical
	Other

Specific Industry, select all that apply:

	Accounting/Finance		Banking
	Biotechnology		Credit
	Electronics		Engineer
	Executive Search		Hotel
	Human Resources		IT
	Industrial		Insurance
	Legal		Manufacturing
	Marketing		Office
	Pharmaceuticals		Printing
	Purchasing		Quality Assurance
	Retail		Sales
	Telecommunications		Temporary
	Truck Drivers

Type of Placement:

	Permanent
	Temporary
	PEO/Leasing
	Other

Fill as many as applicable.

Branch 1:

First Name		Last Name
Title		Organization
Address
Address (cont)		Locality
City		State, Zip
Phone		Fax
Email		URL

Branch 2:

First Name		Last Name
Title		Organization
Address
Address (cont)		Locality
City		State, Zip
Phone		Fax
Email		URL

Branch 3:

First Name		Last Name
Title		Organization
Address
Address (cont)		Locality
City		State, Zip
Phone		Fax
Email		URL

Branch 4:

First Name		Last Name
Title		Organization
Address
Address (cont)		Locality
City		State, Zip
Phone		Fax
Email		URL

If you have additional branches, please contact Kris at our offices: 630-655-0563, and we will be happy to assist you.

Payment Information

Check---Please send all checks made payable to:

Illinois Staffing Association
P.O Box 597292
Chicago, IL 60659

Phone: 773-290-3240


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