Job Seeker Enrollment

® 135 Franklin Ave Scranton, PA 18503 (570) 963-4671/Fax (570) 963-4927

Job Location *Business Name______*Contact______*Address: ______*City: ______*State: ______County: ______Zip: ______*FEIN#______*Phone______*Fax______*E-mail______

Job Details Job Title:* ______Keywords: (1)______(2)______(3)______Enter minimum requirement levels Required Experience: Years _____ Months _____ Education Grade Level: ______(0-19) Enter only if required. Education Degree:  High School Diploma  GED  Professional Certificate

 Vocational/Technical School  Associates Degree  Bachelors Degree  Masters Degree  Doctorate Degree  N/A Major: ______

*# Openings: ______*# Referrals Requested: ______

*Salary: $______per ______Enter minimum based on minimum experience and education level. Do you want this salary displayed to job seekers?  Yes  No (If No, “COMPETITIVE SALARY” will be displayed) Commission:  Yes  No

Type of Work:  Full Time Part Time *Number of Hours/Week: _____

Category of Work:  Permanent  Temporary  Seasonal  Summer  Contract  Apprenticeship *Number of Days: _____ (0-3) _____ (4-150) _____ (150+)

Shift:  Day  Evening  Night  Weekend  Rotation

Is transportation required?  Yes  No

*Required Items *Job Summary: Please provide specific details regarding job duties, job skills, days and hours of work, and any other special requirements. ______

Referral Methods: Do you want your company name on this job order displayed to the public?  Yes  No

Level of Service:  Unassisted -- (Employer conducts own job matches, reviews resumes and interviews job seekers without the help of Pennsylvania CareerLink Staff.)  Assisted -- (Employer would like Pennsylvania CareerLink Staff to assist in screening and referring job seekers.)

Enter any or all applicable: Method of Application:  Resume  Job Application

*Method of Contact:  E-mail: ______ Web Site: ______ Phone  In-person  Fax  Local Pennsylvania CareerLink  Mail (choose any or all of the mail address types below):  Company Address  Job Location Address  Point-of-Contact Address

Additional Information: ______For Office use only:

PA CareerLink Staff Person Accepting Order:______Is the employer (business) a Federal Contractor Job Listing?  Yes  No Is the employer (business) under a court ordered Affirmative Action Plan?  Yes  No *Ownership: ______*Job Order Source: ______*Job Order Category: ______*O*Net ______DOT ______*NAICS ______SIC ______

Staff Information______