1. Name: ___________________
Cotina Murray
Business Resource Representative
Business Labor, Licensing and
Department of Services Representative
Address: ____________________
Regulation
____________________________
Division of Workforce Development
Dorchester County Career Center
____________________________
627 Race Steet
Phone:Cambridge, MD 21613
________________
Fax: __________________
410-901-4242 Phone
Email: _________________
410-221-1817 Fax
cmurray@dllr.state.md.us
JOB ORDER FORM Website: _______________
www.mwejobs.com
EMPLOYER DATA:
Company Name: ____________________________________________ Telephone: _______________________________
Street: ___________________________________________________ Fax: _____________________________________
City: _____________________________ State: ______ Zip: _____________ URL: ________________________________
Contact Person: ________________________________________________ E-mail: _______________________________
Type of Business: _______________________________________________ FEIN # (Required):
_____________________
Are you a federal contractor? Yes No
JOB DATA:
Job Title: ______________________________________________________ No. of Openings: _______________________
Salary: _______________ per_____________ No. of Applicants Needed: ____________ Training Available: Yes No
Part Time / Full Time Temp / Perm Hours per Week: _____________ Minimum Age: ______________
Days to be Worked: ______________________________________ Hours to be Worked: _______________________
Experience: (years)____ (month)____ Min. Education Req’d:____________________ Licenses(s) Req’d:___________________
Physical Demands of Job (circle): Light Medium Heavy Indoors Outdoors
Special Skills Req’d:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
JOB DESCRIPTION
___________________________________________________________________________________________________________
_
___________________________________________________________________________________________________________
_
___________________________________________________________________________________________________________
_
APPLICATION PROCEDURES: (Circle all that apply)
Staff Assisted: Yes No Unassisted: Yes No
Call for Appointment ___________ Apply in Person _____Fax /Mail Resume _____ E-mail Resume _________
When to Apply: _____________________ Closing date: _______________ Job Reference #: _______________________
Testing Req’d: Yes No If yes, what type:
______________________________________________________________
Type of Interview: Phone One-on-One Group Written Oral
Inventory Form #96612-OES530 (rev. 04/2010)

2. THANK YOU FOR ALLOWING THE ONE-STOP CAREER CENTER TO SERVE YOU!
PLEASE ATTACH ADDITIONAL PAGES (INCLUDING PREPARED JOB DESCRIPTION) IF NEEDED.
Auxiliary aids and services are available upon request to individuals with disabilities.
Inventory Form #96612-OES530 (rev. 04/2010)