South Coastal Career Centers - Quincy Career Center Back to Work Info Form

Quincy Career Center
152 Parkingway
Quincy, MA 02169
Phone: 617-745-4046
Fax: 617-745-4049

Back to Work Information

As part of our agreement with Employers, we request information from your company/organization when you hire an individual. The Quincy Career Center requires accurate up-to-date information in order to continue to provide the ability of others to utilize our services. Thank you for your cooperation.

All Information Is Strictly Confidential!

Please Note: All fields marked with an asterisk (*) are required fields.

* Company Name:
* Contact Name:
Email Address:
* Phone:
New Hire Information
* Employee Name:
* Last 4 digits of SS#:
Address:
City, State, Zip Code :
Phone:
* Start Date:
* Job Title:
* Hourly Wage:
* Number of Hrs per Wk:
Permanent Position?
Temporary Position?
How Long?:
Health Benefits?
401K/Pension?
No Benefits?