Thank you for taking the time to fill out our short form, so that we can most
effectively present your credentials to our client. This will also help us
become more knowledgeable of your background and interests. We all dislike
filling out forms, so we have diligently tried to make this as painless as
possible. Therefore, a lot of this is point and click. We promise to
give our best effort in making the next five minutes you spend on this form time
well spent.
Please provide the following contact information:
First Name
Middle Initial
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone
Work Phone
Mobile / Other
E-mail
Please list the jobs or positions you feel qualified for (i.e. Design Engineer,
Project Manager, Senior Technical Lead, Manufacturing Engineer)
Reason for job search:
Lay off - Downsized
Advancement opportunities
Relocation
Looking for more challenges
More money
Starting career
Changing career
Unemployed
Other
Are you currently employed?
YesNo
If no, when was the last day you worked?
-- mm/dd/yy
Your most recent emplyer:
Company Product or Services
Your Current/Last Title:
Years of Experience:
Have you ever managed people?
YesNo
If so how many at one time?
CURRENT OR LAST SALARY INFORMATION
Please scroll and highlight the appropriate amount representing your current or
last base salary, rounded off to the closest thousand. This should not
include bonus or other additional income. This type of income can be accounted
for in the next section.
Additional Salary information(Please do not use $ signs, decimal points
or commas)
Actual Base Salary Bonus( if applicable)
Desired Salary
Minimum Salary
Please choose one (1) industry from the list below, as
the primary area most closely associated with your background. You will be
asked to chose additional secondary industries in the following step.
Other
Please choose from the following list other industries that you would classify
as secondary in your background, not as strong as your choice above, but still
are areas you have been exposed to. (Hold down the Control button to make
multiple choices)
Other
You may find yourself wanting to respond to the
next few questions with some of the same terms. This is not a problem,
since companies in today's business world classify skills,
processes and industries almost interchangeably and vary
dramatically from company to company. We encourage you to use the terms
you feel most comfortable with.
With what PROCESSES are you experienced? (Metal fab,
Injection Molding, Machining, Stamping, Chemical Batch Processes, etc.)
What particular SKILLS do you have that may
be of value to a future employer? (Design, Product Development, Process
Improvement, Manufacturing Supervision, etc.)
What PRODUCTS are you experienced with? (Circuits,
Valves, Plastic Containers, Air Conditioners, Motors, Automotive Parts, etc.)
Relocation requirements:
If we may suggest, there are usually two levels to
express acceptable location of future employment:
1)Those
locations that you"Will consider"for the ideal job
2)Those
locations that you"Prefer"
It is always in your best interest to keep your "Will
consider" locations as broad as possible, and then be selective in choosing
which individual positions you move forward to the next level of your search,
(ie. phone conversation, interview, offer, etc.)
Please select the states you "Will consider"as relocation options for good
opportunities and fill in specifics in the"Preferred
Locations"box. You may select as
many as you desire. The more open you are, the more likely a good opportunity
will be available. (Hold down Control button to make multiple selections.)
Preferred Locations:
Please select the appropriate status of your current residence:
Number of people to relocate if necessary:
Open to travel?
YesNo
Percentage of travel open to:
%
May we utilize all of our extensive resources including the IPA (Inter-City
Personnel Association) and Top Echelon networks of affiliates? (There is no
obligation and absolutely no expense to you for utilizing any of our resources.)
YesNo
EDUCATION
Associates Degrees, training or other education beyond high school and below the
Bachelor's level
Certifications (P.E., Journeyman, CPA, etc.)
Citizenship (US):
YesNo
If no, what is your Visa status:
other:
Expiration of Visa:
-- mm/dd/yy
Please use this space to give us any
additional information that you feel would be helpful to us in finding the ideal
opportunity for you. This information should include things like career
accomplishments, areas of expertise, additional training or certifications,
etc.
Please paste your resume into the area below.
We appreciate you taking a few minutes to fill out this form and realize, as we mentioned above, that no one likes to do this kind of thing. All this information will help us support you and your job search effort. We look forward to working with you.
Copyright © 2002 Clifton Johnson Associates. All rights reserved.
Revised: 9/2009