Nova Management Inc.

Client New Hire. (To be completed by client)

*Required information

*Your Name:

Your Email:

*Your Phone Number:

Client Company Information

Client Company Division:

Hourly Pay Rate:

Start Date:

Work State:

Will the employee have Internet access?: Yes No

Department Number:

PO#:

Employee Supervisor:

Supervisor Email:

Supervisor Phone Number:

Description of job duties:

New Hire Information

*First Name:

*Last Name:

Middle Initial:

*Home Telephone:

Cell Phone:

Email:

Background Check

Please check which test you would like

Drug Test
Criminal Background Check
DMV

Additional Request (Please Specify):