Executive Recruiters, Headhunters, Job Placement Professionals

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Personal Information

  • Select Recruiter:

  • First Name:
  • Street Address:
  • State:
  • Country:
  • Home Phone:
  • Personal Email:
  • List any languages you speak:

  • Our firm is part of a private network of recruiters which shares resumes and job orders. May we network your resume with these other recruiting firms?

  • May we share your resume? (Why?)
  • Postion Applying For:

  • Last Name:
  • City:
  • Zip:
  • Work Phone:
  • Cell Phone:
  • Work Email:
  • Work Status:

Employment Information

  • Currently Employed:
  • Current Employer:
  • Employer Industry:
  • Reason Considering Employment Change:
  • Current Salary:
  • Minimum Salary:
  • Interested In Contract Work?
  • Do You Have a Non-Compete Clause?

  • Please state if you are responsible for reimbursement to your current employer for relocation or educational expenses if you leave before a certain date.

  • Employer Expense Obligations: (Explain)
  • Opportunities Of Interest:
  • Your Last Day Worked:
  • Position Title:
  • Employer's Parent Company:
  • Companies We Should Not Contact:
  • Desired Salary:
  • Other Required Benefits:

  • In order to avoid conflicts, please list any companies with locations that you have already been in touch.

  • Other Companies Contacted: (Explain)
  • Please Explain:
  • Please Explain:

Educational Information

  • Primary Degree:
  • Primary Degree Type:
  • Primary Degree Institution Name:
  • Primary Degree Completion Year:
  • Primary Degree GPA:

  • Please list any licenses/Certifications you have. Examples - CPA, ASP, CMA, CPIC, CSP, SPHR, PHR, CPIM, PE, CEBS, CCP, CPM

  • Licenses/Certifications: (Examples)
  • Secondary Degree:
  • Secondary Degree Type:
  • Secondary Degree Institution Name:
  • Secondary Degree Completion Year:
  • Secondary Degree GPA:

Relocation Information

  • Will You Relocate:
  • Relocation Preference:

  • Is there anything else we need to know about relocation?

  • Addition Information: (Explain)

  • Are there any special needs that might impact your job change - i.e. employment for spouse, schools for children, etc.?

  • Special Needs: (Explain)

  • Select any other places you would relocate. Hold down the CTRL key to make multiple selections.

  • Other Preferences: (Help)

Reference Information

Reference One
  • First Name:
  • Relationship:
  • Email:
  • Last Name:
  • Phone:
Reference Two
  • First Name:
  • Relationship:
  • Email:
  • Last Name:
  • Phone:
Reference Three
  • First Name:
  • Relationship:
  • Email:
  • Last Name:
  • Phone:

Your Resume

  • Other Background:

  • .doc - Microsoft Word
    .xls - Microsoft Excel
    .pdf - Adobe Reader
    .txt - Text File
    .rtf - Rich Text Format

  • Upload Resume: (Allowed Filetypes)

Face to Face Interview

Consider this survey information submitted by a major recruitment service: “Hiring managers often know whether they might hire someone soon after the opening handshake and small talk. Executives polled said it takes them just 10 minutes to form an opinion of ...�


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Telephone Interviews

Many employers conduct telephone interviews to screen candidates for basic qualifications. It is also an alternative when it is not practical to invite an out-of-area candidate to the office.


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"I have worked with Phillip both as a candidate and as a customer. I must say he has appreciation for the complexities of the manufacturing process and the unique demands it makes on leadership. He has the personal experience to understand and identify what makes strong candidates. One other thing…he will question my own judgment and push me to revisit some of my personnel decisions."


Jim S.

Plant Manager

Human Resources