Full Name

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Email

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Today\'s Date

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Phone number with area code

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Why are you looking for a new position?

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Are you the sole source of household income?

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No. of dependents in household (not including yourself)

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Describe recent employment experience

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Education level & Major Course of Study

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Desired Position

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Special experience, skills and/or certifications

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Desired Salary

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Min. Salary you\'re wililng to accept

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Are you willing to relocate?

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Any relocation considerations (housing, children in school, other special considerations)?

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Describe current status of your job search effort (Networking, Job Boards, Internet Sites, etc.).

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Where have you applied?

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Have you been rejected or turned down any employment offers?

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If so, from who and why?

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Do you have a Resume prepared?

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Do you need assistance in preparing a Resume?

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Do you have a letter(s) of recommendation?

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