NOTE:  Fields with an '*' are required

Personal Information

* First Name:
* Last Name:
* Address:
* City:
* State:	Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
* Zipcode:	(format 99999  -or-  99999-9999)
* E-Mail Address:
* Home Phone:	(format 999-999-9999)
Cell Phone:	(format 999-999-9999)
Other Phone:	(format 999-999-9999)

Business Information   (complete if you will be invoicing PDR through your business)

Business Name:
Address:
City:
State:	Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zipcode:	(format 99999  -or-  99999-9999)
Tax ID Number:

General Information

What is your typing speed?	wpm
List all software programs you are experienced with:
Do you own a laptop computer?	Yes      No
Windows Version:
Type of Internet Access:
Court Research Experience?	Yes      No
If yes, please list companies:
How many hours available per week?
On which days are you available?
Are you willing to travel?	Yes      No
Please list counties available to work:
Please list quantity of new records available each week for counties listed above:
Please list any/all data collection experience:
Rate your Administrative skill level:   1 lowest —> 10 highest
Please explain your rating using examples:
Rate your Time Management skill level:   1 lowest —> 10 highest
Please explain your rating using examples:
Rate your Dependability level:   1 lowest —> 10 highest
Please explain your rating using examples:
Please rate the selection that fits your personality: #1=Best Fit    —>   #5=Least Fit Loyal   Dependable   Analytical   Consistent   Perfectionist
Please elaborate on your first and second selections:
Please list any additional information that will assist us in choosing you for this position:

References

Please list a minimum of three references that we may contact. For professional references, list the Company and Title/Occupation.

Reference #1:	Personal      Professional
Name:
Years Known:
Phone:	(format 999-999-9999)
Company:
Title/Occupation:
Reference #2:	Personal      Professional
Name:
Years Known:
Phone:	(format 999-999-9999)
Company:
Title/Occupation:
Reference #3:	Personal      Professional
Name:
Years Known:
Phone:	(format 999-999-9999)
Company:
Title/Occupation:

I hereby affirm that I have answered the questions contained in this questionnaire honestly and to the best of my ability. I understand that you reserve the right to confirm any of the information that I have provided. I also understand that if I am selected as a Court Researcher for you, I am required to sign a Confidentiality Agreement and supply you with a criminal background report.

Check here to signify your agreement with the above statement Please Note: If you are applying from outside of the United States; please send a resume to researcherteam@prodataresearch.com.