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Resume Pre-Screen Questionaire

ALL MATERIALS WILL BE KEPT IN STRICT CONFIDENCE
MARINO & ASSOCIATES, INC. is an equal opportunity employer.
Please answer a few questions about your capabilities and the type of position you are seeking. When a potential match arises, we will be sure to contact you.

Please also attach your resume (as a Word document) to this E-Mail message in addition to filling out this form.

Disclosure Statement: I understand that all information is confidential. I understand that Marino & Associates, Inc. will only provide information to their clients with my consent. I warrant all facts contained herein to be true and complete and hereby authorize Marino & Associates, Inc. to act as my agent and to use the information provided while seeking employment opportunities on my behalf. I have read and understood the above.

Name:

You would describe your work experience under which general heading?
Referred by:

Home Phone:

Work Phone:

Cell:

Email Address:

What would be your ideal position (List 2):

What salary would you like in your next position?

K
What is your minimum salary you would accept?

K

EMPLOYMENT EXPERIENCE

(Last 10 years)
Title:

Mo/Yr From:

To

Company:

Base Salary:

Bonus:

Commission:

Total annual salary:

Motivation for leaving current or last position:

Title:

Mo/Yr From:

To

Company:

Base Salary:

Bonus:

Commission:

Total annual salary:

Reason for leaving:

Title:

Mo/Yr From:

To

Company:

Base Salary:

Bonus:

Commission:

Total annual salary

Reason for leaving:

Any gaps in employment:

Why:

Any Supervisory experience:

If yes, where and when:

# of people supervised:

Describe your search activity over the past
3-6 months. Please include any information about interviews/offers you have had as well as the types of positions, etc.:


What companies would you like to work for:

How far are you willing to commute to and from work:

What salary do you expect in your next position:

What are your thoughts concerning susceptibility to a counteroffer from your current employer:


Have you ever been given one in the past:

Did you accept it or turn it down:

Why:


Are you expecting an offer? If so, where?

How did you find out about the offer?

What other search firms/agencies or resources are you currently using in your job search?

Referrals: Who would you recommend as someone who is excellent at their job? Currently looking?