Employer Request Form

	GRADUATE PLACEMENT SERVICES Santa Rosa Junior College
EMPLOYER REQUEST FORM

COMPANY__________________________________________PHONE____________________

CONTACT PERSON*__________________________________PHONE____________________

ADDRESS_________________________________________________DATE______________

No. Street City Zip Code

TYPE OF ORGANIZATION______________________________________________________

JOB TITLE_________________________________________________________________

NUMBER OF POSITIONS AVAILABLE_________________
HOURS PER WEEK_____________

SALARY RANGE__________________________________
SPECIFIC DAYS______________

DUTIES / RESPONSIBILITIES:

BASIC QUALIFICATIONS REQUIRED AND/OR SPECIAL SKILLS, EXPERIENCE OR ACADEMIC BACKGROUND PREFERRED:

`APPLICANT SELECTION PROCESS:`
`[ ] Send Resume to the Contact Person* (listed above)`
`[ ] FAX Resume to #_____________________Attn:___________________________`
`[ ] Other_______________________________________________________________`

Please FAX form to: (707) 524 - 1712 (fax) GRADUATE PLACEMENT SERVICES Santa Rosa Junior College Bussman Hall 1501 Mendocino Ave. Santa Rosa, CA 95401 (707) 527 - 4690, Career Developer

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`JOB TITLE_________________________________________________________________`
`NUMBER OF POSITIONS AVAILABLE_________________`	`HOURS PER WEEK_____________`
`SALARY RANGE__________________________________`	`SPECIFIC DAYS______________`

EMPLOYER REQUEST FORM