Date Created (mm/dd/yy):

Accounting
Administrative
Computer/Data Processing
Executive Level         
Engineering
Human Resources
Manufacturing
Material Management     
Purchasing
Quality Control
Sales/Marketing
Other                   

Current Salary/Rate    

Desired Salary/Rate    

Minimum Salary/Rate 

Currently Employed:    Yes     No

Current or Last Employer:

Industries Worked in:         

          1.     

        2.    

        3.    

        Skill and Qualifications:   

       Available Date:(mm/dd/yy)   

       U.S. Citizen:   Yes      No          

        If Not, Residence/Visa Status   

        Foreign Languages:
                                     1.      Read        Write    

       2.     Read          Write   

       3.     Read          Write