Registration Form
(Filling this form out will aid in our effort for you. Please fill out every category)
Please click on the recruiters name that you have been in contact with. (If you have not been in contact with one, you may choose Gary Edward's)
Gary Edwards Lori Pearlman Norman Coswell
Are you interested in a PERMANENT FULL TIME position ? (We are a full time placement agency only, and do not have contract positions) YES or NO (Required)
Home Phone # (Required)
Work Phone#
Cell Phone or Pager
Tell us How you found our Web site. i.e.
(Which Search Engine)
Current Security Clearance & Status (Required) None, I have never held one But I am A US Citizen I am NOT A US Citizen Not active, but I have held a TOP SECRET clearance in the Past Not active, but I have held a SECRET clearance in the Past Secret Secret/SAR Secret/SBI Secret/SSBI Top Secret Top Secret/SBI Top Secret/SSBI Top Secret/EBI Top Secret/BI Top Secret/SCI Department Of Energy (DOE) clearance
If Clearance is not Currently active, What was it's last active date ?
Are you authorized to work in the USA ? i.e. (Green Card, H-1, F-1) (Required)
Married Yes No
Own Home (For Relocation Purpose) Yes No
Current Salary (If unemployed, what was your last salary) (Required)
Salary Expectations (At least give us a range) (Required)
Geographic Areas of preference: (Very Important !!!) We need to know all the locations that you and your family would go for the right $ Money and Opportunity (Please be specific) Telling us: "Mid West" or "East Coast" can be Easily Misinterpreted. We will not send your Resume to any locations that you do not specify, so be sure and include all locations that you would entertain (Required)
Geographic Areas that you will NOT entertain.
I am currently employed: Yes No
If NOT Currently Employed, When did your last job end ?
What are your work hours ? or if you are unemployed state the best time to contact you
Please name 2 Technical References / phone #'s / and their professional relationship to you that can vouch for your Technical Abilities. (These References will not be contacted without your approval)
Please list the companies that you have recently (in the past 3 months) Physically Interviewed With, so that we do not duplicate any efforts that may be pending. (Please include the Locations of these companies, as many Employers have Numerous locations) (Required)
Please list the companies that you have recently Submitted your own Resume to, or have had another Recruiting Agency submit your resume to, so that we do not duplicate any efforts that may be pending. (Please include the Locations of these companies, as many Employers have Numerous locations) (Required)
Is your resume posted to any Major Job Boards ?
None Career Builder Monster Dice Numerous Job Boards
Educational Background (Degrees) and Dates your degrees were granted
Tell us your Specialty:
Tell us what type of position you are most interested in. i.e.(Electromagnetic Code development, Program Management, Radar Systems, Hardware Development etc.) As our goal is to learn as much as possible about your interests, and what type of position it will take to pique your interest, and upgrade your Career.
Would you like to gain Additional Exposure to your search ? By allowing us to Network with other Recruiters, can give you additional exposure to your search, thus additional interviews and offers are likely (This service is also free of charge)
Yes No
What would you like to ask us?
Comments: i.e. How can we improve our Services or your experience with us? Can we modify our web design for easier Navigation? etc.
You may Paste or Type your resume below If you have already sent us your resume, there is no need to do it again. Simply tell us where to look for your resume (Required) I have Pasted it below in this Form I have Already sent a copy Via Email I will send a copy Via Email After Submitting this Form I have applied to an On-Line Posting, so you should already have a copy I will FAX it to you I have Hard Mailed it to you
Your Resume:
Please only hit the "SUBMIT NOW" button once. It may take a moment to send
Having Problems with this Form ?
Call us.. 810-636-4330
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