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Contractor Application

We will use the following information to match you with one of our clients. Please be as complete as possible and if you have any questions please email us at dsmith@expertit.com

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1. Please enter the ID number of who referred you ... ?

2. Please identify and describe yourself:

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   First Name
   Last Name
   Middle Initial
   Date of Birth

3. Please provide the following contact information:

   Street Address
   Address (cont.)
   City
   State/Province
   Zip/Postal Code
   Country
   Work Phone
   Home Phone
   FAX
   E-mail
   URL

4. Select any of the following languages that you are proficient in :

   Assembler	ADA	APL
   ASP	ActiveX	Basic
   C	C++	CGI
   CICS	COBOL	COBOL-Object
   Cold Fusion	CORBA	COTRAN
   CPM	Clipper	Delphi
   DOS	Forbal	Fortran
   Forth	GNET	HTML
   Interdev 1	Interdev 6	J++
   Java-Visual	Java	JCL
   OBDC	LISP	PASCAL
   PASCAL-Turbo	PERL	Pronexus Voice
   PL1	PAL	Power Builder
   Realizer	REXX	RPG
   RPG-Object	RPG 400	SAP
   SAS	Smalltalk	SGML
   SHTML	SQL	TSO
   UNIX	Visual Basic 2	Visual Basic 3
   Visual Basic 4	Visual Basic 5	Visual Basic 6
   VBA 2	VBA 3	VBA 4
   VBA 5	VBA 6	Visual Voice
   XML	Xlisp

5. Enter any languages you work in that are not listed above:

6. Select any of the following database platforms you program in:

   Access 2	Access 4	Access 97	Access 8
   Access 2000	DB 1	DB 2	DB 3
   DB 4	DB 5	Informix	IQ
   Oracle	Oracle 7x	Paradox	RBASE
   Sequel	SQL 4x	SQL 6x	SQL 7
   Sybase	Spectrum	Supra 2

7. Enter any database platforms that you work in that
    are not listed above:

8. 
   

9. Select any of the operating systems you can administrate:

   Alpha	Apple	AIX
   AS400	Linux	MSDOS
   NT 3	NT 3x	NT 4
   Win 2000	OS2	UNIX
   VAX/VMS	Windows 3x	Windows 3xx
   Windows 95	Windows 98	Windows 2000

10. Enter any operating system you can administrate that are not listed above:

    
    

11. Select any of the hardware you have experience with:

    IBM Mainframe      IBM PC and clones  MAC                DEC              
    

12. Enter hardware platform specifics below, like HP 3000, System
     36, AS 400 & ETC.:

    
    

13. Please list any certifications that you have below. Please separate with a comma:

    
    

14. What is your highest educational degree attained.

    
    

15. Enter the Industries in which you have work experience, like Health, Insurance, Government:, and ETC:

    
    

16. How many years have you been in this field... ? 
    

17. How many years have you been consulting ? 
    

18. Enter an hourly consulting rate desired ( anticipating a one year contract)?
    

19. Enter your hourly consulting rate for short projects (3 months or less) ? 
    

20. Enter the rate you are working for now ? 
    

21. Select possible working arrangements:

    Full time Contract  Part Time Contract  Hourly              Temp only         
    Temp to perm        Full time employee  Part time employee
      All of the above

22. Are you willing to travel ?  Yes No
    

23. Are you willing to relocate ?  Yes No
    

24. What are the titles of the jobs you are most qualified for? Separate with commas:

    
    

25. Biography 1: Please fill in the following three biographical information paragraphs, we intend to use them for our reference and to talk you up to our clients only at this time. Please list the most successful projects you were ever on and how you contribute as short couple of sentences like... I was the project manager for a successful Y2K effort for the 7th largest Medical association in the world. We remediated 12,000 PC's and 245 servers. Under my direction we completed this project within budget and under the timeline.. ?

    
    

26. Biography 2:

    
    

27. Biography 3:

    
    

28. Please list any additional information you feel would be important to our recruiters and clients. ?

    
    

29. Are you available to start work tomorrow?     Yes No
    

30. Please enter a password that we can use to secure your information: 
    

31. Please enter the above password again:. 
    

Thank you for taking the time to fill in this form. We look forward to working with you. If you need any assistance or other information please email us at dsmith@expertIT.com.

Copyright © 1999 Expert IT Consultants.  All rights reserved.
Revised: October 15, 2000.