Maxim Staffing Solutions

Use the form below to register for permanent employment or consulting and subcontracting assignments. All information you send to us will be held in the strictest confidence. Under no circumstance will representation be made on your behalf without your prior authorization.
* Indicates a required field.

Basic Information

Please provide some basic contact information. This will help us communicate any opportunities to you as quickly as possible.
Name *
Nickname
Address

City	State/Prov. *
Zip *
Country	E-Mail *
Current Employer
Current Title *

Certification and Licensure

What professional certifications do you currently hold?
What licenses do you currently hold?
In what states are you currently licensed?

Desired Position

What type of position do you desire?

Modality

What other modalities are you eligible for?

Relocation

Are you willing to relocate?

Travel

How far are you willing to travel?

Telephone Numbers

Tell us the numbers where we can reach you. (*only 1 required)
Home:
Work:
Mobile:
Pager:
Primary:
Secondary:

Resume

In addition to copy and pasting your resume into the database, you can upload your formatted resume thats in MS Word, RTF, HTML or PDF format by clicking the browse button and locating the document on your local drive. When you save your profile the document will be uploaded and available for recruiters to access.

Document to Upload:
Title of Document:

Current Documents

Paste your resume here from any word processor. To do this, go to your word processor, pull up your resume, hit your [Ctrl] [A] on your keyboard, hit your [Ctrl] [C] on your keyboard, click in the box below then hit [Ctrl] [V].

Future Access

It is very important that you keep a record of your Login and Password. We will not share this information over the phone, nor by any means. Write it down and keep it in a place you will remember.
Login: *
Password: *