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1. Print this page or copy it to an e-mail message.
2. Complete as much information as you feel is appropriate.
3. Fax it to (530) 582-0415 or e-mail it to rlongo@longo.com
NOTE: Information provided remains confidential and will only be disclosed
to our clients with your specific prior authorization.
Date:_________________ Name:______________________________________________________________ Position(s) of Interest:___________________________________________ ___________________________________________________________________ Current Position:__________________________________________________ Company:___________________________________________________________ Company Location:__________________________________________________ Functional Experience:_____________________________________________ ___________________________________________________________________ ___________________________________________________________________ Key Technology/Qualifications/Certifications:______________________ ___________________________________________________________________ ___________________________________________________________________ Years of Experience:_______________________________________________ Technical Preference(s):___________________________________________ Education/Degree(s):_______________________________________________ ___________________________________________________________________ Other Training:____________________________________________________ ___________________________________________________________________ Please contact me by: ___ Phone (Day/Evening): ___ Fax: ___ E-Mail:
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