• Job Order Recruiter
  • Client Company Information
  • Candidate Information

Submit a Placement

Once you've finalized all the details of a contract placement with your client company and contract candidate, your work is almost complete. You need to submit the necessary information to Top Echelon Contracting by completing the fields below. We use this information to generate the necessary legal agreements and employment paperwork for the client company and contractor. The accuracy of this information is essential.

Get Started (Person completing these forms or contact person)
  • Job Order Recruiter
  • Client Company Information
  • Candidate Information
Step 1
Job Order Recruiter
Mail Checks To:
Step 2
Client Company Information
Address at work location:
(No PO Boxes)
Many locations throughout the United States have passed laws that require employers to provide mandatory paid sick time to their employees. Top Echelon complies with all State and Municipal Paid Sick and Safe time laws and ordinances. Sick and Safe time rights are specific to the city or state in which the employee works. If your contractor is working in a location that requires mandatory paid sick time, Top Echelon will be providing paid leave to satisfy the sick time requirements. This will reduce your recruiter profit.
Timesheet Approver
Contract Contact
Send Contract To
Invoice Contact
Send Invoices To
$/ hr
$/ hr
Is the Client Company sales tax exempt?
If yes, please fax the exemption certificate or applicable tax exempt document to fax number (330)455-2374
We recommend that the recruiter negotiates a Conversion Fee Agreement directly with the client company so that the recruiter's conversion fee is in place in the event the client would like to hire the candidate as their employee.
A suggested Letter Agreement for Contract Staff Recruiting Services is located here to assist the recruiter in this process.
If necessary, we can accommodate adding the recruiter's conversion fee into our Client Services Agreement.
Please note however, Top Echelon Contracting does not take any responsibility for invoicing a conversion fee or enforcing any conversion fee in our Agreement.
Step 3
Candidate Information
Home Address:
(No PO Boxes)
NOTE: Top Echelon Contracting conducts a drug screen and criminal background check on every healthcare worker we employ. The cost will be split between Top Echelon Contracting (30%) and the recruiter (70%). The recruiter's share will be deducted from his or her first recruiter check from Top Echelon Contracting.
$ / hr
$ / hr
$ / hr
Due to the new healthcare reform, Top Echelon Contracting must adhere to a minimum pay rate. Please contact our office if you anticipate paying the contractor less than $15.00 per hour to discuss.
Indicate if you want the candidate to receive Paid Leave Days.
Note: This will reduce your recruiter commission.
Comment Box
Please include any specific details pertaining to this placement
NOTE: The information provided on these forms is used to generate binding legal documents. Please confirm that all information supplied to Top Echelon Contracting is accurate.

A copy of this data will be emailed to the address entered here (for your records). Separate email addresses with a semicolon.