The Career Place Home Page Job Fair Registration Form
  for Job Seekers who are not already registered at The Career Place

The Career Place is funded in part with Federal and State funds. Collecting specific information allows us to earn our funding, and demonstrates our public service. Your information is never shared or sold to other groups. For your convenience and to save time at the job fair, please print this form in advance, complete it, and submit it to Career Place staff at the job fair. Thank you for your assistance.


First Name

Initial

Last Name

Street Address

Zip Code

City: _________________________________   State: ________   Country: _____________________

Social Security Number:

Gender:   Male     Female

Race/Ethnicity: 

White

Black or African/American

 

Hispanic or Latino 

American Indian or Alaskan Native

 

Asian

Hawaiian Native or Other Pacific Islander

 

 

Other

Military: 

U.S. Military Veteran

 

Military Other Eligible (spouse of 100% disabled veteran)

 

Date of Birth: Month____________________ Day _____ Year _____________

Home Telephone: (______) _______ - _____________ Email: __________________________________

Employed:     Yes     No

Previous/Current Employer: ______________________________ Job Title:______________________

City: __________________________ Start Date: _______ / _______ / _______

How did you hear about the Job Fair?
The Career Place website   The Career Place events calendar   E-mail notice
Poster/flyer (where did you see it?):______________   Newspaper (what newspaper?):________
Cable tv (what town?):______________   Other:____________

 

 ____________________________________________

 

______________________________

Customer Signature

Date

The Career Place
Trade Center Park, 100 Sylvan Road, Suite G100, Woburn, MA 01801
Phone: 781.932.5500 * Toll Free: 1.888.273.WORK * TTY Users: 781.932.5552
www.CareerPlaceJobs.com