Employer Company Name: Contact Person: FEID#: Federal Contractor? Yes No Address: City:      State:   Zipcode: Phone: Fax: Email Address: Position Job Title: Is the Job Permanent?    Yes No    -- If no, how long will the position last?   How much does the position pay:  $     Per:   Job location:      Hours/week:   Days and times of work: Months of Experience Required: Years of Education Required: N/A   12   AA/AS   BS/BA   MS/MA   PhD Are you willing to train? Yes No Specific Licenses, Certifications, College Degree or Permits required:     Drivers License required? Yes No    -- If yes, what class?   Are typing skills required? Yes No    -- If yes, WPM:   Is computer experience required? Yes No    -- Specified software:   Specify any special machines or equipment the applicant must be able to use:     Job Description:     Job Benefits:     Application Resume required? Mail   Fax   E-mail resume Call for Appointment; Times:    Apply in person; Location: Special Instructions or Requests:

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