Action Recruiters

First Name:

Mark Nagle   Beth Lynch

Last Name:

Address 1:

Address 2:

City:

State:

Zip Code:

Please Check one:    U.S. Citizen   Permanent Resident   Other

If other please explain

Home Phone:

Work Phone:

Cellular Phone:

Pager #:

Fax:

E-Mail:

2nd E-Mail:

Homepage URL:

My location preference:
(please explain)

Would you consider locating elsewhere? Yes No

Comments:
(Any information that may help us serve your better)

Important: Please send us your resume!
action@netins.net

The following information is necessary to represent you.

1. Are you Looking for:

Full Time   Contract Both

2. What is your present annual income or contract rate?

3. What do you expect to receive as a minimum annual income.

4. What do you expect to receive as a minimum hourly contract rate?

5. For relocation purposes, are you married?

Married Single

6. For relocation purposes, do you own your own home?

Own Rent

7. What type of position do you feel would best fit you?

Technical Skill
/ language

Years of
experience
Last
used

Example:
   C++       5 1997

8. Please list your technical skills (languages) and years of experience.



















9. How much management experience do you have (please explain)

10. Is the above your current Management experience? Yes No

11. Why are you looking for a new position (please be specific):

12. Are you interested in a position that requires travel?     Yes     No

      If "yes" what percentage of the time would be acceptable?     %

13. What security clearance do you hold if any?

14. What is your technical passion?

Thank you for your submission.

We look forward to working with you.

Sincerely,