SPCI Job Order Selection Form
Keep one copy of this page active and press "Submit Form" after you have made all your selections.

Check the job order numbers for which you would like more information:

A47494 C45789 F75337 J63589 J64042 J87163
N32706 P17881 P37745 P63468 R14333 R38598
R53836 S33489 S66706 T24561 V84465 W20191
W85104 X25915 Y16290 Y66350 Z67554
Personal Information:
First   Last
City State   Zip
Home Work   Cell
Primary Email Home Work
Other Email Home Work
Travel: Up to. %

Willing to relocate: Yes No
If yes, would you consider paying your own relocation expenses? Yes No Maybe

Will do vendor support (check all that apply):
Product Support Level 1 Level 2
Product Development 
Technical Marketing
Quality Assurance

Citizenship Status:
U.S. Green Card Canadian Other
(choose the leftmost one that applies)

Least Acceptable:

Job Type you will consider: 
Employee (W2)
Consultant (1099) 

  Attach a resume:

Additional information?