Alien Labor Job Order Information Request Form

The following information is required in order to properly place your Alien Labor Certification job order with Iowa Workforce Development. This form is used for employers seeking both temporary and permanent Labor Certification. Please complete the form in its entirety. If you have questions, contact Denise Schippers at (515) 281-7538 or by e-mail to:  A red asterisk * indicates a required field for the form to be submitted.

Employer Information: (Where alien will work)

*Employer/Business Name:
 *Employer/Business E-mail:
*Employer/Business Street Address:
City, State, Postal Code:
 *Employer/Business Area Code +Telephone:
 ### - ### - ####
 Employer/Business Area Code + FAX:

Contact Person Information (Where to send résumés)

*Contact Person's
First and Last Name:
*Contact Person's E-mail:
*Contact Person's
Street Address:
*Contact Person's
City, State, Postal Code:
*Contact Person's Area Code +Telephone:
 ### - ### - ####

Wage Offer Information:

*Job Title:
*Number of Openings:
*Specify: Total Hours Per Week:
*Specify: Work Schedule:
Start and Quit Time & Days Per Week
(Example: 9 am - 5 pm M-F)
*Specify: Exact Rate of Pay:
(Rate or Amount Per Hour or Per Week
or  Annual Salary)
Additional Compensation
(i.e., Bonuses, Overtime and etc):

Job Description:

*Job Description:

Education Requirements:

*Level of Education Required:
*Total Months
of Training Needed:
*Total Months
of Experience Needed:
Other Special Requirements:


Type the characters shown in the GREEN box above.
Used to prevent automated form submission.

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