Boss & Associates

First Name

MI

Last Name

Address (Street, City, State, Zip Code)

Home Telephone Number

Cell Telephone Number

Email Address

Are you legally authorized to work in the United States?

National Origin:

Have you had prior contact with Boss & Associates?

Placement Consultant you worked with:

What source referred you to Boss & Associates?

Brief Overview (current role / responsibilities):

Motive for Job Change:
(If currently employed), what is your current level of job satisfaction (1-10)?

What reason(s) would you have to resign and pursue an opportunity with another organization?

What are you currently considering?

If we presented an ideal position, is there anything that would keep you at your current employer?

Explain:

Create your Personal Criteria 'Checklist':
What is your ideal role and what is most important to you when choosing a company? Describe the function, capacity, type of company, and top 3-4 things you look for and evaluate (in order of importance) when choosing a career opportunity.

Compensation:
At what compensation level does an opportunity become worthy for pursuit?

What is the lowest acceptable base?

What is your current compensation package? Annual Salary:

Bonus/Commission @ 100%:

Equity/Other elements associated with your total Compensation Package:

Annual Earnings:

Year to Date

Prior Year

Two Years Ago

Where are we coming into the picture?
Are you passively searching?
Are you actively looking?
How long have you been looking?

Please share the companies you have already evaluated or ones you might be pursuing or engaged in conservation with so we respect and don't duplicate efforts.Please include any information about interviews and/or offers you have had in the last 6 months as well as the types of position(s) you have evaluated.

What are you currently considering? What is most compelling at this point? How far along in the process?

Are you currently working with other recruiters? Yes No. If yes, how many firms have your resume?

3-5 companies you respect and would have interest in even if it meant a lateral move:

Identify 3-4 key attributes that make you stand out compared to others in your field:

REFERENCE RELEASE FORM

All our clients require business/peer/subordinate references from prospective candidates. It is our standard procedure to check references BEFORE referring you to one of our clients, or even before we confirm an interview with you. Signing the disclosure statement below allows us to check your references, which will only be done when we deem it necessary to further the placement process or to verify information you have given us. If you are working, we realize that in most cases you cannot use your current manager as a reference. Managers from previous employers are acceptable as are trusted peers in your current company as well as past clients that can speak to your work and accomplishments.
Reference information is always kept in the strictest professional confidence.

Professional References:
List 4-6 professionals who know of your work, contribution, capabilities and character. At least two should be someone you have worked directly for (former or current manager or client). The others may be peer references (former or current co-workers). If you had direct reports please provide two subordinates that you have supervised. Please provide the reference name, contact information including phone number and email address, and the nature of the working relationship.

Name, Contact Information, Nature of Relationship

Many of our clients have stringent hiring processes and conduct extensive background checking. Have you ever been convicted of a crime, including any felony or misdemeanor other than a minor traffic violation? Yes No.
If yes, please explain:

Education / Special Skills / Technical Training
Special Training, Course or Certificate Received; Date of Completion

(Highest Formal Education Completed)
High School Diploma or GED Associates Degree
BS/BA or other Bachelor's Degree Major:
Master's, Doctorate, or other Post-Graduate Degree. Title of Thesis (if applicable):

Disclosure statements for all candidates to understand and acknowledge in working with our firm:

1. All personally identifiable applicant information provided by you will be properly safeguarded and the use of such information will be limited to valid business, regulatory or legal requirements.
2. You must be legally authorized to work in the United States and the state in which you are applying (i.e., meet employment eligibility requirements under the Immigration Reform and Control Act of 1986, meet applicable minimum age requirements, etc).
3. This application is not an employment contract and should not be construed or interpreted as creating an implied or expressed contract of employment between the Company and its applicants.
4. Boss & Associates may verify information provided on this application and conduct reference checks to identify information regarding character, work record, general knowledge and capabilities, and reputation. By signing this form, you authorize the Company to make these inquiries and you indicate your awareness that false statements or failure to disclose information may be sufficient to disqualify you for referral to client-employer.

By signing the Digital Signature, I acknowledge the above-mentioned terms and agree.

Digital Signature: