CANDIDATE DATA SHEET

 

Current Title/Position:   

Position Seeking:    

Name:  

Address:  

City:      State:    Zip:  

I.  Contact Information

Home Phone:  --   Work Phone:  --

Mobile Phone:  --

Email Address:  

II.  Employment Information

a. Current Position: 

b. Reason for Leaving:

c. What You Like About Current Position: 

d. Previous Position: 

e. Reason for Leaving: 

f. Areas of Interest: 

g. Skills & Accomplishments: 

h. How Long Looking: 

i. Most Recent Resume Submissions: 

j. Interviews Within the Last Three Months:  YES NO

With Whom: 

III.  Relocation

Willing to relocate:  YES NO

Willing to travel:  YES NO         How Much?

a. Geographic Preferences:

   1. 

   2. 

   Not willing to go to: 

b. Own/Rent: 

IV.   Personal Information:

a. Spouse/Significant Other:

    Name: 

    Occupation: 

    Number of Children: 

b. Current Compensation:

    Base: $     Bonus: $     Total: $ 

    Minimum Desired Compensation:

    Base: $     Bonus: $ 

c. Education: 

d. Citizenship:  U.S. Other

    (If "Other" is checked -- please provide Visa Status)  

e. Have you had a DWI/DUI or been convicted of a felony within the last 7 years?

    YES NO

     If yes, please provide details:
    

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