Corporate Industrial Staffing, Inc.

Create an Employer Account — Company Information

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(* required fields are in red)

Part One: Company Information
* Company Name
* Company Description
(1,000 characters max.)
1,000 remaining
FEIN
DUNS No.
* Office Locations
Please select the office which would be most convenient.
Aurora, IL
Dixon, IL
Rockford, IL
Sterling, IL
Woodstock, IL
Hastings, MN
Janesville, WI
Lake Geneva, WI
River Falls, WI
West Bend, WI
Part Two: Primary Contact (Primary contact serves as the account administrator. Password must contain at least eight alphanumeric characters, at least one of which is a number.)
Please note: The password and its minimum requirements are in place and enforced for our (your AND my) protection. One day, when computers are equipped with retinal and DNA scanners, we won't need passwords at all. . . unless you're in the habit of loaning out your eyes. . . or we're all clones. . . or robots.
* First Name
* Last Name
* Title
* Email
* Email Confirmation
* User Name
Numbers or letters only, please. All other characters, including spaces, will be removed.
* Password
* Password Confirmation
* Primary Contact's Phone (ext.)
Part Three: Address (Please enter the physical address of your company.)
* Street Address eg. [123] [Main St.]
(Suite number)
* City
* State
* Zip +4
Company's Phone Number
Please provide your company's general number if it is different from above.
Fax
Part Four: Terms and Conditions Agreement
Agreement between Corporate Industrial Staffing, Inc. (COMPANY) and CLIENT
Print the Agreement

I certify that I am an authorized agent for (CLIENT) and have read, understood, and agreed to the aforementioned terms and conditions.

Use name and email address from above.
* First Name
* Last Name
* Email
Date