CAI – Personnel Search Group
CANDIDATE DATA SHEET PO Box 962, Brentwood, TN 37024-0962
NAME: PREFERRED NAME: SOCIAL SECURITY #:
OPTIONAL
ADDRESS: E-MAIL ADDRESS:
CITY: STATE: ZIP CODE: HOME PHONE NO.: MOBILE PHONE NO.:
BUSINESS PHONE (LIST DIRECT LINE OR 800 NO. IF YOU HAVE ONE OR BOTH)
MAIN NO.: 800 NO.: DIRECT LINE: EXTENSION NO.: (IF APPLICABLE):
CITIZENSHIP: U.S CITIZEN: YES NO RELOCATION: On printed copy, shade ZIP map depicting acceptable location.
PERM RESIDENT: YES NO The map section does not work online, put your relocation selections in the area to
the left.
FEDERAL SECURITY CLEARANCE:
LANGUAGE SKILLS:
5
ARE YOU OPEN TO CONTRACT/TEMPORARY WORK?
9 4 1 0
WHAT TYPE OF POSITION ARE YOU SEEKING? 6
8
ALL 2
Preferences 7 3
1.
2.
Will Not!
INDUSTRY PREFERENCE:
RELOCATION PREFERENCE(S): DO YOU HAVE A HOME TO SELL IF YOU RELOCATE?
DOES YOUR SPOUSE IF YES, WILL THAT BE A FACTOR IN WILL YOU TRAVEL? IF YES, HOW MUCH?
WORK? YOUR DECISION TO ACCEPT A NEW GIVE PERCENTAGE:
POSITION?
YOUR CURRENT/LAST SALARY: MINIMUM SALARY ACCEPTABLE TO HOW WERE YOU REFERRED TO US?
YOU:
IF YOU MOVE, WHAT ONE PERSON WILL KNOW HOW TO CONTACT YOU? List Name, Relationship, Address and Phone #.
PLEASE GIVE YOUR SPOUSE’S NAME AND WORK PHONE NO.
COMMENTS:
EDUCATION: GIVE NAME OF SCHOOL, LOCATION OF SCHOOL, DEGREE RECEIVED, DATE RECEIVED, & GPA:
I agree that all job information furnished to me by Cook Associates International is considered confidential business information and
will not be disclosed to any individual or other company by me at any time.
I hereby give Cook Associates International the right to make a thorough investigation of my past employment, education, and
training which would include the verification of the information set forth on this application. I release from all liability all persons,
companies and corporations supplying information. I indemnify Cook Associates International against liability which might result
from making such an investigation.
APPLICANT DATE
EMPLOYMENT HISTORY SUMMARY: (Please list most recent first)
COMPANY NAME: PARENT COMPANY:
COMPANY LOCATION: TELEPHONE NO.:
PRODUCTS/SERVICES:
SUPERVISOR’S NAME/TITLE:
NUMBER of PEOPLE YOU SUPERVISED: YOUR JOB TITLE:
ENDING SALARY: EMPLOYMENT DATES (from-to): LAST DAY WORKED:
REASON for LEAVING:
COMPANY NAME: PARENT COMPANY:
COMPANY LOCATION: TELEPHONE NO.:
PRODUCTS/SERVICES:
SUPERVISOR’S NAME/TITLE:
NUMBER of PEOPLE YOU SUPERVISED: YOUR JOB TITLE:
ENDING SALARY: EMPLOYMENT DATES (from-to): LAST DAY WORKED:
REASON for LEAVING:
COMPANY NAME: PARENT COMPANY:
COMPANY LOCATION: TELEPHONE NO.:
PRODUCTS/SERVICES:
SUPERVISOR’S NAME/TITLE:
NUMBER of PEOPLE YOU SUPERVISED: YOUR JOB TITLE:
ENDING SALARY: EMPLOYMENT DATES (from-to): LAST DAY WORKED:
REASON for LEAVING:
COMPANY NAME: PARENT COMPANY:
COMPANY LOCATION: TELEPHONE NO.:
PRODUCTS/SERVICES:
SUPERVISOR’S NAME/TITLE:
NUMBER of PEOPLE YOU SUPERVISED: YOUR JOB TITLE:
ENDING SALARY: EMPLOYMENT DATES (from-to): LAST DAY WORKED:
REASON for LEAVING: