Employment Opportunities


Personal Information
Full Name: " . $_REQUEST["LastName"] . ", " . $_REQUEST["FirstName"] . " " . $_REQUEST["MiddleInitial"] . "
Email: " . $_REQUEST["Email"] . "
Phone: " . $_REQUEST["Phone"] . "
Alternate Phone: " . $_REQUEST["PhoneAlt"] . "
Address: " . $_REQUEST["Address"] . "
Address: " . $_REQUEST["Apt"] . "
City: " . $_REQUEST["City"] . "
State: " . $_REQUEST["State"] . "
Zip: " . $_REQUEST["Zip"] . "
Over 18: " . $_REQUEST["rbnOver18"] . "
SSN: " . $_REQUEST["SSN"] . "

Employment Information
Employed: " . $_REQUEST["rbnEmp"] . "
If so, Contactable: " . $_REQUEST["rbnContactEmp"] . "
Experience: " . $_REQUEST["PastExp"] . "

Education Information
Higher degree: " . $_REQUEST["rbnGrad"] . "
Enrolled in College: " . $_REQUEST["rbnCollege"] . "
If so, Where: " . $_REQUEST["College"] . "
If so, Major: " . $_REQUEST["Major"] . "
If so, Graduation Date: " . $_REQUEST["GradDate"] . "

Skills and Strengths
Skills and Certifications: " . $_REQUEST["Skills"] . "
Strengths: " . $_REQUEST["Strengths"] . "
Other: " . $_REQUEST["Other"] . "

Resume or Vitae
Provided: " . $_REQUEST["Resume"] . "

All information was submitted via the EMS Group website. " ; $headers = "" ; $headers .= "MIME-Version: 1.0\n"; $headers .= "Content-type: text/html; charset=iso-8859-1\n"; $headers .= "X-Priority: 1\n"; $headers .= "X-MSMail-Priority: High\n"; $headers .= "X-Mailer: php\n"; $headers .= "From: " . $fromemail ; //send application to ems mail( $emsgroupemail, $subject, $message, $headers ); //send receipt to person applying mail( $fromemail, $subject, $message, $headers ); $Success = 1; echo "Thank you for completeing our online application!.

An email was submitted to the respective managers as well as a receipt to yourself.

Thank you for your time."; } else { //error message echo "Please be sure to fill out all fields denoted with a(n) *" ; } ?>

Contact Information
First Name*
" size="20">
MI
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Last Name*
" size="32">
Email Address:* " size="42">
Home Phone: " size="18">
Alternate Phone: " size="18">
Permanent Home Address:* " size="31">
Address Line 2 (If required): " size="31">
City:* " size="20">
State:*
Zip/Postal Code:* " size="10">
Are you over 18?* > Yes > No
Social Security Number:* " size="20">
Employment Details
Are you currently employed? >Yes >No
If so, may we contact your current employer? >Yes >No
Past work experience:
(please list all previous employers, dates employed and contact numbers)
Education
Do you have a Higher Education Degree? >Yes >No
Are you currently enrolled in college? >Yes >No
If so, where? " size="25">
Major/Focus of study: " size="25">
Expected graduation date: " size="15">
Skills & Strengths
Skills/Certifications: (Limit to 10 Lines or less)
Strengths: (Limit to 10 Lines or less)
Other Information: (Limit to 10 Lines or less)
Resume or Curriculum Vitae
Do you have a resume or curriculum vitae?