Employer Staffing Request Questionnaire

This questionnaire helps Lomean Inc. understand your staffing needs clearly and accurately, allowing us to identify and place candidates who are the best possible fit for your organization, culture, and operational requirements. Send your response to Partnerships@lomeaninc.ca.

1. Organization Information

Legal organization name:
Email address:
Phone number:
Organization address:
Industry / sector:

2. Staffing Request Overview

Position title(s) required:
Number of staff needed:
Type of engagement (select all that apply):
- Temporary
- Part-time
- Full-time
- Casual / On-call
- Contract / Project-based
Anticipated start date:
Expected duration of assignment (if applicable):

3. Schedule and Availability Requirements

Work schedule (days and times):
Shift length:
Overtime or extended hours required? (Yes / No)
Weekend or evening work required? (Yes / No)
Flexibility required? (Please specify):

4. Role Responsibilities

Please provide a brief description of the role and key responsibilities:

Primary duties:
Reporting structure (who will the staff report to?):
Level of independence required:
Team-based or individual role:

5. Required Qualifications and Experience

Minimum education or training required:
Required certifications or licenses (if applicable):
Minimum years of experience:
Technical or job-specific skills required:
Physical or operational requirements (if applicable):

6. Workplace Environment and Culture

Understanding your workplace culture helps us ensure alignment.

Work environment (office, field-based, remote, hybrid):
Pace of work (fast-paced, moderate, structured):
Team size:
Core values or organizational culture to be aware of:

7. Compliance, Safety, and Screening Requirements

Background checks required? (Yes / No)
Vulnerable sector check required? (Yes / No)
Drug or alcohol testing required? (Yes / No)
Health and safety training required? (Yes / No)
Any additional compliance requirements:

8. Performance Expectations

Key performance indicators or success measures:
Critical timelines or deliverables:
Probation or evaluation period (if applicable):

9. Past Challenges or Considerations

Have you experienced challenges filling this role in the past?
Skills or traits that did not work previously:
Any additional context we should be aware of:

10. Ideal Candidate Profile

In your own words, describe the ideal candidate for this role:

11. Authorization and Acknowledgement

By submitting this questionnaire, you confirm that:

The information provided is accurate and complete to the best of your knowledge;
You are authorized to submit this request on behalf of your organization;
You acknowledge and consent to the collection, use, and handling of information as outlined above.

Confidentiality, Privacy, and Information Handling

Lomean Inc. is committed to protecting the confidentiality and privacy of all information provided through this questionnaire. All employer information, staffing requests, and related documentation are collected, used, stored, and disclosed strictly for the purpose of assessing staffing needs and providing workforce support services.

In accordance with The Freedom of Information and Protection of Privacy Act (FIPPA) of Manitoba, Lomean Inc. takes reasonable steps to ensure that:

Personal and organizational information is collected only as necessary for legitimate business and staffing purposes;
Information is accessed only by authorized personnel who require it to perform their duties;
Information is safeguarded against unauthorized access, use, disclosure, or loss;
Information is retained only for as long as necessary to fulfill the identified purpose or meet legal and contractual obligations.

Information shared with Lomean Inc. will not be disclosed to third parties without consent, except where required or permitted by law.

If you have questions regarding how your information is collected, used, or protected, or if you wish to request access to or correction of your information, please contact Lomean Inc. at info@lomeaninc.ca.