Company Logo


Please be aware that this job order form must be for temporary jobs related to public or private non-profit agencies for projects to assist with clean-up, humanitarian aid, and restoration activities to an area affected by a natural disaster. Clean-up may include debris removal and sanitation of facilities. Such work must be on public property, unless workers from units of general local government are also authorized to conduct and are performing such work on the private property. Workers will be assigned through agents of CareerSource Broward. Their wages will be paid for by a national emergency grant and not by public or private non-profit agencies to which they’re assigned.

You must complete one form for every type of job.


Agency Name:
City: State: Zip:

Contact Person:
Telephone #: Fax #:
E-mail Address:


Job Title:
Hourly Wage Rate: $
Is the rate of compensation for this position the same as employees who are working in similar occupations within your organization and who have similar training and experience?
List a description of job duties:

Job location(s) if different from above address:

City: State: Zip:
Worksite supervisor(s) if different from above contact and known at this time:

Number of Positions Needed:
Education Level Required:

Type of Experience Required:

Required Skills, Licenses, etc.:

Other Requirements or Information:

Work Schedule - Days of the week:

Hours each day: From     To

Total Hours Per Week:

Preferred start date:     Projected end date:

Supplies required:

Dress code or uniforms needed (e.g., steel-toed boots required):


What type of equipment will the participant be using?

Will the participant be working off the ground (e.g., on a ladder, climbing trees, etc.)?
If yes, how high off the ground? feet

Is there a need for the participant to operate a vehicle?
If yes, what type of vehicle?

Does the job require any of the following: (check all that apply)

Employer has not requested or been awarded FEMA funds for the positions identified in this job order.

Thank you for choosing CareerSource Broward to assist with your human resources needs.

An equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities.