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PERSONAL INFORMATION:

Name	First	Last
E-mail Address:
Home Phone #:
Address	Street (Suite, Apt, Floor) City State Zip Code Choose a State Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachussetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Republic of Palau Rhode Island South Carolina South Dakota Tennessee Texas U.S. Virgin Islands Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

GENERAL INFORMATION:

How much experience do you have? 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 years

Are you willing to relocate? Yes No

What area would you like to relocate to? If yes... Choose a City Dallas Austin Houston

When were you registered?

Last time updated?

How long does it take you to remove and install each of these units? (EXAMPLE: 2 hours 30 min)

4T60E	4L60E	A-604
A-606	Honda O.D.	AXOD
RL4F01A	E4OD

Out of 100 units, how many will be R & R related CB's? 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

How many removes and installs will you average per week?

Can you build? yes no

Rate yourself on a scale 1-10, 10 being the best:

Multicheck 0 1 2 3 4 5 6 7 8 9 10	Snap on scanner 0 1 2 3 4 5 6 7 8 9 10	Final drive adjustments 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50
Assist manager with telephone 0 1 2 3 4 5 6 7 8 9 10	Production management 0 1 2 3 4 5 6 7 8 9 10	Owner cooperation 0 1 2 3 4 5 6 7 8 9 10

11.) How many days of work have you missed in the last 12 months? 0 1 2 3 4 5 6 7 8 9 10

12.) How many days have you been late to work in the last 12 months? 0 1 2 3 4 5 6 7 8 9 10

TELL US WHAT IS IMPORTANT TO YOU IN YOUR WORKING ENVIRONMENT:

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