Candidate Questionnaire

Date

Name*

First Last

Home Phone

Cell Phone

Personal Email*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your Preferred Method Of Contact (Cell, Personal E-Mail, etc.)?

Are You Currently Working With Any Other Recruiters? *

What Companies Have You Already Been Presented To?

To What Companies Have YOU Personally Applied?

EMPLOYMENT INFORMATION

Currently Employed?

Name of Current or Most Recent Employer:

Do You Have A NON-COMPETE With Your Present Employer? *

Dates of Employment:

Current or Most Recent Job Title:

Briefly List Your Responsibilities:

City and State of Current or Most Recent Employer:

Work Phone Number:

OK to Call You at Work?

Work E-mail:

OK to E-mail At Work?

How Are/Were You Compensated? (Salary, Hourly, Commissioned)

What is Your Annual Base Pay?

W-2 Total Earned Income Last Year:

List Insurance Provided by Employer (Health, Dental, Vision, Life)

What is Your Monthly Contribution For Insurance?

How Many Vacation Days Annually?

How Many Sick Days Allowed Annually?

How Many Paid Personal Days Allowed Annually?

Does Your Employer Offer A 401K, Pension or Retirement Plan?

What Are The Contribution Details Of This Plan?

What Other Perks Does Your Employer Offer?

What Are Your Hours Of Work?

How Long Is Your Commute?

List The Positives About Your Current/Most Recent Employer

Any Negatives?

Why Would You Now Consider Making A Career Change?

What Are You Looking For In A New Employer That You Don’t Have With Your Present/Most Recent Employer?

What Type Of Position Are You Seeking? *

What Is Your Realistic/Desired Salary Range?

What Is Your Maximum Commute?

What Percentage Of Travel Will You Accept?

Are There Any Companies That You Would NOT Work For? If So, Please List:

RELOCATION INFORMATION

Will You Relocate?

Preferred Locations For Relocation:

Where Would You NOT Relocate?

RELEVANT CAREER EXPERIENCE

Describe Any SALES Experience:

Describe Any OPERATIONS Experience:

Describe Any CUSTOMER SERVICE/COORDINATING Experience:

Describe Any MANAGEMENT Experience:

Describe Any FINANCIAL/ACCOUNTING Experience:

Describe Any INTERNATIONAL RELOCATION Experience:

List The Positions You Have Held In The HHG/Relocation Industry:

List Any Professional Memberships Or Professional Organizations:

List Any Achievements, Honors or Awards:

List The Names of Your FORMER Employers In Order From Most Recent To The Earliest:

RESUME INFORMATION

Do You Have A Current Resume?

If So, Please Cut And Paste Here:

Have You Eliminated ANY Information From Your Resume?

If So, Please Explain:

Are You A High School Graduate?

Are You A College Graduate?

Were You Ever In The Military?

List Any Skills, Accomplishments or Information NOT Specified On Your Resume (For Instance, “CMC / COIC” IOMI Certified, Etc.):

REFERENCE INFORMATION

Please Provide 2-3 PROFESSIONAL References:

Provide 2-3 PERSONAL REFERENCES:

Other Than Your Present Employer, Who May We NOT Contact?