Galileo Placement Form

Placement Information
Type of Placement
Start Date
MM slash DD slash YYYY
Full Name: Candidate/Contractor*
New Title
Source: Candidate and Job Order
Recruiter*
How did the Candidate learn about this job?*
Exelare - Job Order - Task - Sub-Type.
Was the Candidate in Exelare?
Candidate Exelare Source
Exelare Candidate Record - Skills Tab - Source & Source Details
Account Manager*
Job Order Source*
To choose more than one: Hold Ctrl + Click
Client Information
Hospital Name
Contact Person
Contact Title
Contact eMail
Contact Phone
Billing Address
Interim
Galileo Hourly Rate $
Contractor Hourly Rate
Per Diem Rate
Client Bill Rate
Direct-Hire
Candidate Annual Compensation $
Galileo Fee %
Invoice Amount $

Placement Information