(RETURN WITH YOUR RESUME) This is not a Contract - No Signature Required
All Referrals are on an Employer Fee Paid Basis.
PLEASE BE COMPLETE
I. PERSONAL
II. EMPLOYMENT INFORMATION
Are you employed?
NO YES Reason for change
If no, why and last day worked
When available for interviews?
When available to start work?
Employer:
Present
Last
Title
Division of:
Products/Services
III. SALARY INFORMATION
Base Salary:
Present
Last
Bonus?
Desired Salary $
Minimum Acceptable $
Date of next scheduled salary review
These are simply guidelines. We understand that location, C.O.L., opportunity for career growth and many other factors will influence the above.
IV. EDUCATION
Degree
Major
GPA
College/Univ.
Date
Grad. Degree
Major
GPA
College/Univ.
Date
Other
V. JOB SEARCH PARAMETERS
Type of position sought (describe or title)
Relocation/Geographic Preferences (describe)
VI. GENERAL
So that we do not duplicate your efforts, please list companies and agencies whom you have contacted, with results thereof
US Citizen:
Yes No
Residence/Visa status
We are occasionally requested by some employers to make reference checks. We do so only at their request and with your permission. May we have two references (one supervisor and one co-worker) from each of your last two employers. Include your present employer only if we have permission to check with the person listed.
Employer:
Present Last
Supervisor (name, title and phone #)
Supervisor EMail Address
Co-worker (name, title and phone #)
Co-worker EMail Address
Next Previous Employer
Supervisor (name, title and phone #)
Supervisor EMail Address
Co-worker (name, title and phone #)
Co-worker EMail Address
How did you learn of our Company?
Would any of your friends or co-workers be interested in our services?
Yes No
If so, may we have their name, titles, phone # and EMail address
R E S U M E
If you have a current resume in electronic format, you can forward a copy to us via the email function of your web browser.
Start the email function of your Web browser by clicking the name of the person to whom you would like to send the resume (shown below) and ATTACH a copy of your resume in either Word or WordPerfect format.
NOTE: If you email your resume to us by clicking one of the names listed above, you will still need to press the "Submit Questionnaire" button below to send us the content of the questionnaire. Please send the questionnaire to the same person who will receive your resume.
VII. DESTINATION
Which individual within Phil Ellis Associates, Inc. should receive this questionnaire?
