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Candidate Profile Form

Name*
First Name Last Name
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Work Phone*
Cell Phone*
Home Phone*
Home Email*
Work Email*
College (Or High School) Attended with years attended or Graduation Date:*
Degree(s)*
Overall GPA*
Hidden
Marital Status
- Single
- Married
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If married, does spouse work?
- Yes
- No
Hidden
If yes
- F/T
- P/T
Hidden
Home Status
- Own
- Rent
Hidden
Any kids?
- Yes
- No
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If so, how many and what ages?
If not a US Citizen, what is your Residency, Green Card or Visa Status?*
What is the motivating factor in your search right now or in looking at new opportunities*
Is there anything or anyone that would prevent you from accepting a new job at the present time?*
What is your current or most recent base salary? Bonus potential & actual?Next expected increase and how much?*
Describe briefly the benefits package with your current company (401K, car, profit sharing, stock options, educational reimbursements, medical and all other benefits, etc)*
How much would you be looking for in total compensation (Break down as base salary & commission/ bonus)?*
Willing to relocate?*
- Yes
- No
If so, what locations?*
What qualities do you possess which would distinguish you from other candidates?*
Have you managed people?*
- Yes
- No
If so, how many and at which position(s)?*
List all significant career awards and accomplishments*
Reasons for all job changes (detailed)*
What percentage of your current position involves overnight travel?*
What percentage are you willing to travel overnight?*
What is your current and desired work environment? (Home based office, office cubicle, on the road, road warrior, etc.)*
Do you have a valid driver’s license?*
- Yes
- No
Any DMV points on license?*
- Yes
- No
Have you ever been convicted of a crime?*
- Yes
- No
If yes, explain*
Describe your ideal job(s) and industry(ies)*
Do you have a non-compete agreement and/ or a reimbursement clause for tuition or relocation assistance?*
- Yes
- No
If so, specify which of these you have*
Provide names of other recruiters that you are currently working with or have worked with in the past 1 year*
Is your resume currently on any Job Boards (Monster, CareerBuilder, HotJobs, etc.)?*
- Yes
- No
If so, which one(s)?*
What are your extracurricular hobbies and interests?*
Provide at least 3 Professional References with name, company, title, and current contact info.
Ref # 1*
Ref # 2*
Ref # 3*
List all companies that you have interviewed with or had contact with regarding employment opportunities with them during the past 1 year. Include company name, position title, date of last discussion (Approx. if not known exactly) and status with each of them*
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