FAX
To: (407) 644-2151 (Holly Horton, Business Manager)
From:______
Date:______
Order for jobadvertisement on EmployeeBenefitsJobs.com
Thank you for choosing EmployeeBenefitsJobs.com! Your ad will run for 60 days.Your cost is $335. (To post your ad directly rather than using this form, click on “Post a Job Ad” at
Job Title (limit one job title per ad): ______
Name of your company, as you would like it to appear in the ad: ______
Job description, job requirements, information for candidates about your company (attach additional sheets if needed; no limit on amount of text):
How should candidates apply for this job?
Enter the state in which this job will be performed (or the states, if you have openings for this job title in several states; or “all states” if the job can be performed in any state): ______
Enter the 5-digit zip code for the city and state in which this job will be performed (or the zip codes, if you have openings for this job title in several cities): ______
Optional: Enter the address of a web page if you'd like your ad to include a clickable linkthat says "Visit our web site (click here)":______
How can we can contact you about this ad, if we need to?
Your name:______
Your telephone number: ______
Your fax number: ______
Your email:______
Billing Information (To whom should we send an invoice? Or enter credit card information below):
Company name:______
Attention:______
Street/Box/Suite:______
City/State/Zip:______
Is this company an advertising agency? ______
Purchase or insertion order number, if any: ______
Optional credit card information, if you would prefer us to charge a credit card:
Type of card:American Express ___ Visa ___MasterCard ___
Card Number: ______
Expiration Date: ______
Name that appears on card: ______
Thank you very much for your business!
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