In the fast-paced world of today, it is sometimes difficult to assess your career position and determine if you are reaching your full potential. Please complete this questionnaire so we can better match you with the position and company that will allow you to realize your fullest potential.
Name of Candidate:
Referred by:
Home Phone:
Work Phone :
Pager/Cell:
What would be your ideal position:
 
Title:
Employment Experience:
Mo/Yr to Mo/Yr:
-
Industry:
Company:
Base Salary :
K + Bonus:
Commission:
K=:
Reason for leaving your current job:
 
Title:
Employment Experience:
Mo/Yr to Mo/Yr:
-
Industry:
Company:
Base Salary :
K + Bonus:
Commission:
K=:
Reason for leaving your current job:
 
Title:
Employment Experience:
Mo/Yr to Mo/Yr:
-
Industry:
Company:
Base Salary :
K + Bonus:
Commission:
K=:
Reason for leaving your current job:
 
Where are you willing to work:
How far will you commute to and from work:
What is your total compensation package:
What are your thoughts concerning susceptibility to a counteroffer from your current employer:
Have you ever been given one in the past:
Did you accept it or turn it down:
Why:
   
                             

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