[checklist name= "Management Solution (CDCR) Rate and Facility" mailto="jsnoddy@teemagroup.com " templatedoc="1XKubwafH6tKdsJv5h0gdn1xJ2u5rLPzGGVbEynxsyGA" templatedrive="1dXMfNGwBvPn47SBZn9qq0CHsq_I9K6wr" savedrive="16xx0Kr8cjf3XhLIFxtkzG1NtGlk5yaA1" sheetid="1ox1JP4JP3K1WJdowd3JtFyd82z83-b7a14-O7BXYitI" submitto="/wp-content/themes/orange/custom-shortcodes/google-services/functions/google-sheets/addFormGoogleSheetRow.php"] [checklistHeading title="Management Solution (CDCR) Rate and Facility Submission Form"] [/checklistHeading] [checklistInputGroup name="Personal Information"] [checklistInput type="text"]Your first name[/checklistInput] [checklistInput type="text"]Your last name[/checklistInput] [checklistInput type="text"]Position title[/checklistInput] [checklistInput type="text"]Facility being submitted to[/checklistInput] [checklistInput type="float"]Hourly rate[/checklistInput] [/checklistInputGroup] [checklistFooter title="Exclusive Authorization" tostext="I hereby authorize TEEMA to submit my resume to the above named client. I attest and confirm that I have not been submitted by any other supplier to this position, nor have I signed or do I intend to sign another Consent Form giving authorization to any other supplier to submit me to the position listed above. I agree to the hourly rate stated above for the duration of the assignment. Please click the Submit button to acknowledge you agree to all the above."] [/checklistFooter] [/checklist]