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Currier Winn Candidate Contact Form

Your Name
Your full name
Street Address
Your street address for receiving information from us.
City, State, Zip Code
Self explanatory
Telephone
The telephone number you would like us to use to contact you.
E-Mail Address*
The E-mail address you would like us to use to contact you.
Education
Please include any degrees earned, dates awarded and GPA
Are you eligible to work in the USA
Yes 
No 
Are you a home owner or renter?
Home Owner 
Renter 
Are you a citizen or Permanent Resident
Citizen 
Permanent Resident 
Other 
What is your current employment status?
Employed 
Unemployed 
If unemployed, what was your last date of employment?
Your current or last employer name.
Division of?
Company product line
What is your position objective?
What is your present salary?
Desired salary?
Minimum Acceptable Salary?
Why are you searching for employment?
When will you be available?
Geographic Preferences (e.g. Cities, States, Regions)
Are there any comments or information that would help us in your search?
We are a member of a national network of recruiting firms. May we share your resume` with them?
Yes 
No 
Date

MM		/
DD		/
YYYY
Please include the date you submitted this form.
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