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EMPLOYMENT REQUEST FORM
CONTACT INFORMATION
Name:
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Address:
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City/State/Zip:
Phone:
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Mobile Phone:
Fax:
E-mail:
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PERSONAL INFORMATION
Social Security #:
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Date of Birth:
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Drivers License #:
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JOB INFORMATION
Start Date:
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Positions Available:
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Electrical - Electrical Department Manager
Electrical - Electrical Design Engineer
Electrical - Electrical Engineer
Mechanical - Mechanical Department Manager
Mechanical - Mechanical Design Engineer
Mechanical - Mechanical Engineer
Plumbing/Fire Protection - Plumbing/Fire Protection Designer
Plumbing/Fire Protection - Plumbing/Fire Protection Engineer
Structural - Structural Bridge Engineer
Structural - Structural Design Engineer
Structural - Structural Project Engineer
Attach Resume:
Desired Salary:
Work Experience or Additional Information To Be Considered
EDUCATION Special Training: Special Skills: EMPLOYMENT HISTORY Most Recent Employer: Address, City, State, ZIP: Starting Date (mm/dd/yyyy): Leaving Date (mm/dd/yyyy): Job Title: Hourly Rate Or Salary: Supervisor's Name: Phone Number: Description Of Work: Reason For Leaving:
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AUTHORIZATION I certify that the facts contained in this application are the truth and complete to the best of my knowledge. I authorize investigation of all statements contained herein, including criminal background check, and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release CBI Group, Inc. from all liability for any damage that may result from utilization of such information.
CBI Group, Inc.
1298 Rockbridge Road, Suite B
Stone Mountain, GA 30087
1-800-875-1292
Bob Bowers – President
bob@cbisearch.com
Greg George – Vice President
greg@cbisearch.com
Amber Marie – Executive
amber@cbisearch.com
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