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First Name		Last Name

Username		Password

Tel		Confirm Password

Email

Seeking Employment In		Current / Last Position (equivalent to)
Scotland
Cumbria & N Lancs		Other Position (from above)
N East & N Yorks
Yorkshire		Current Industry
Merseyside & N Wales
North West		Other Industry (from above)
E Midlands & E Anglia
N Midlands		Current Employer
W Midlands
S Wales & S West		Current / Last Basic Salary
M5 Corridor
M4 Corridor		Bonus (insert amount)
South
South East (north)		Driving Licence
South East (south)
London		I agree to be contacted by email or telephone
Comm to Croydon
Ireland