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:

A30237 C85649 D84597 E94321 F75337 H99781
K23054 K80124 K88049 N11450 P17881 P37745
Q13849 Q20606 Q87494 R53836 R80139 R83096
T24561 V60603 W41157 W80443 X25915 X26806
X61115 Y66350
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?