Candidate Registration

PCS Office*
Personal Information
First Name*
Last Name*
Gender*
Birthdate*
Month
Day
Year
Address*
Street Address Address Line 2 City State ZIP Code
Cell*
Home Phone*
Email*
Please use the same email address you used when submitting your resume.
Spouse's Name
Spouse's Email
Marital Status*
How did you hear about PCS?*
Employment Information
Industry you would like to work in:*
Full- or part-time?*
Please specify part-time hours:*
Employment Status:*
Name of current employer:*
Do you have a college degree?:
- Yes
- No
- Enrolled
What is your salary requirement
Time willing to commute:
List the computer applications you know:

Eg: Word, Excel, QuickBooks, Graphics, Java.
Experience
Name of the company previously employed by:
Industry you were previously working in:
Years experience in your last role:
Other Industry you were previously working in:
Other role, years experience:
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Comments:
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List up to 2 references
Name Phone City State
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List up to 4 courses you're interested in taking
Course Time to take Interest
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Course 1 - Choose
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Course 1 - Time to Take
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Course 1 - Interest
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Course 2 - Choose
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Course 2 - Time to Take
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Course 2 - Interest
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Course 3 - Choose
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Course 3 - Time to Take
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Course 3 - Interest
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Course 4 - Choose
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Course 4 - Time to Take
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Course 4 - Interest
Consent*
In order for us to accept your application and assist in your job search you need to agree to the following terms:

I understand that by attending meetings with a PCS representative, I am confirming & giving my word of honor that PCS is offering their services to me on the condition that I will inform PCS if I get a job - be it through PCS or any other way.

This is necessary in order that PCS can effectively use their resources to help those who are unemployed.
I AGREE
Please Confirm By Typing Your Full Name*

Name	Phone	City	State

Course	Time to take	Interest

Personal Information

Employment Information

Experience

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