Candidate Information Sheet Date: Name: Phone Numbers: (Last) (First) (Cell): (Home/Alt): (MI) Home Address: Email Address: 1. Current or prior LISC Employee? 2. If yes, current/prior position title (and company- if not currently on a LISC contract): 3. If yes, what is/was your current base pay? 4. What is your current clearance level? 5. If yes, what is your current status? (Circle all that apply) st 1 shift nd 2 shift $ Y N Per Hour $ Which agency holds your current clearance? (DoD…) rd 3 shift Per Year When was your clearance last adjudicated? Part-Time Full-Time Seasonal Rotating shift 6. If yes, please state types of benefits for which you are/were eligible (e.g., medical, dental, etc.): 7. Have you applied to LISC positions online? 8. If yes, please indicate the title(s) or requisition number(s) and which company (GDIT or Raytheon): 9. If you have not applied, please indicate which position(s) and location(s) which you are most interested: 10. Have you or are you applying to positions outside of the LISC contract? Y N Candidate Information Sheet Training and Certifications: Please check all certifications that you have obtained. Please use the blank sections to add any certifications not listed. CompTIA Security + CompTIA Network + Planner/controller per vehicle for TM TAA-3C TAA-3C-1 TAA-3C-2 TAA-50-1 TAA-50-2 TAA-50-3 TAA-50-5 TAA-8A TAA-24A CTPS Display CTPS BAPS PDTS Digital Recorders Receivers Decom IMDS ESD Separation data switch Antenna Cert Antenna Climbing Certs Lockout/tag out Notice: Resumes, applications and any information provided to RGNext may or will be shared with either or both of the parent companies, Raytheon and GDIT. All three companies will comply with confidentiality laws and regulations. However, by applying to RGNext, you will only be considered for employment opportunities available at RGNext. To be considered for employment opportunities with Raytheon Company please visit: http://jobs.raytheon.com/ To be considered for employment opportunities with GDIT please visit: http://www.gdit.com/Careers/ OFFICE USE ONLY Job Title: Other Information: Unique ID #: Parent Organization: Interviewer:
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