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Please enter your profile.  All underlined fields are required.

Name: 
(Ex: John Doe)
Street Address: 
Address (cont.): 
City: 
State: 
Zip Code:   
Home Phone:   (Ex: 972-555-1212)  
Work Phone:  (Ex: 972-555-1212 x22)  
Mobile Phone: 
E-Mail: 
Job Title: 
(Ex: CFO, Treasurer, Director of Audit, etc.)
Desired Title/Position: 1st Choice:   2nd Choice:  
Are You Open To Relocation? Yes No 
If Yes, Are You Open To Opportunities Anywhere? Yes No 
What Are Your Top 2 State Preferences?   
What Are Your Top 2 Region Preferences?     
Other Relocation Considerations: 
(Ex: No Coasts or Prefer Warmer Climates or KY, OH, MI, IN, etc.)
Current Base: Desired Base:  
Current Bonus: Desired Bonus:
Current Equity: Desired Equity:
   
Besides Pay and Benefits, What 4 Things Are You Looking For In Your Next Opportunity?
Please Explain Your Last 3 Employment Changes:
What Would You Consider Your Top 5 Business Accomplishments?
What Are Your 3 Greatest Strengths?
What Are Your 3 Greatest Weaknesses?
References (Only list those that will not jeopardize your current position.)
3 Managers
NameTitleCompanyPhoneEmail
3 Peers
NameTitleCompanyPhoneEmail
3 Subordinates
NameTitleCompanyPhoneEmail
 
Availability Date To Begin: 
% of Travel Preferred: 
Last W-2 Amount: 
(This is optional. However, upon offer preparation, our Clients may ask us to verify W-2 information.)
   
Resume
(Make sure to attach your resume)
   
Send this resume to:  David Thaler
Hunter Trego
Jack Marsh
Joe Wales
   
Job ID/Reference (if any): 


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