Application Form
PLEASE DO NOT WRITE IN SHADED AREAS
Recruiter # 1: Recruiter # 2:
TODAY'S DATE:
TO BE CONSIDERED FOR EMPLOYMENT WITH OUR COMPANY, APPLICATION MUST BE COMPLETED IN ITS ENTIRETY. SS#
RESIDENCE ADDRESS
APT #:
FIRST NAME
MIDDLE
LAST
CITY
STATE
ZIP
PREFERRED NAME / NICKNAME SERVICE AREA (WHAT KIND OF WORK ARE YOU LOOKING FOR?) o Administrative o Professional o Engineer o Brokerage o I.T. o HR o Accounting o Medical o Office Services o Technical o Insurance o Mortgage o Other
MAILING ADDRESS (IF DIFFERENT) HOME PHONE ---
o Sales & Marketing o Banking o Finance
WORK / OTHER PHONE
--
--
MOBILE PHONE OTHER PHONE(S) OR EMAIL ADDRESS
--
--
Type Of Career Placement Arrangement Acceptable (Circle Preferred Or Both)
Employer Paid Fee
Temp-To-Hire
Email Address:
EDUCATION (Please list most recent first)
INSTITUTION NAME o High School INSTITUTION TYPE o Community College o University o Technical or Trade School o Other
CITY DEGREE TYPE o Certification o BA o BS o High School
STATE
o Attended College/no degree o Associates Degree o Special Training o PhD
o Master of ________________
MAJOR STUDY
MINOR / OTHER STUDY
o Course work in progress
INSTITUTION NAME o High School INSTITUTION TYPE o Community College o University o Technical or Trade School o Other
CITY DEGREE TYPE o Certification o BA o BS o High School
STATE
o Attended College/no degree o Associates Degree o Special Training o PhD
o Master of ________________
MAJOR STUDY
MINOR / OTHER STUDY
o Course work in progress
INSTITUTION NAME o High School INSTITUTION TYPE o Community College o University o Technical or Trade School o Other
CITY DEGREE TYPE o Certification o BA o BS o High School
STATE
o Attended College/no degree o Associates Degree o Special Training o PhD
o Master of ________________
MAJOR STUDY
MINOR / OTHER STUDY
o Course work in progress
Ambassador Executive Search is a Equal Opportunity Employer, M/F/V/ADA
PRESENT AND PAST EMPLOYERS (Please list most recent first) *Required PRESENT OR MOST RECENT EMPLOYER
*COMPANY NAME TYPE COMPANY? JOB TITLE
CITY / STATE
*SUPERVISOR'S NAME *START PAY $__________ per _________
*PHONE
SUPERVISOR'S TITLE
*END PAY
$__________ per _________
INCENTIVE/BENEFITS JOB DESCRIPTION *START DATE MO_________/ YR _________
*END DATE REASON FOR LEAVING:___________________________________________________________________ DOES THIS COMPANY USE RECRUITING/STAFFING FIRMS? WERE YOU PLACED BY AN AGENCY? PART TIME?
MO_________ /YR ________
o
YES
o
NO
o
NO
YES
o
NO
HOW LONG WERE YOU UNEMPLOYED BEFORE BEGINNING THIS JOB?
o
YES
o
NAME OF AGENCY: _____________________________________________________________________________________________
PREVIOUS EMPLOYER
*COMPANY NAME TYPE COMPANY? JOB TITLE
CITY / STATE
*SUPERVISOR'S NAME *START PAY $__________ per _________
*PHONE
*SUPERVISOR'S TITLE
*END PAY
$__________ per _________
INCENTIVE/BENEFITS JOB DESCRIPTION *START DATE MO_________/ YR _________
*END DATE REASON FOR LEAVING:___________________________________________________________________ DOES THIS COMPANY USE RECRUITING/STAFFING FIRMS? WERE YOU PLACED BY AN AGENCY? PART TIME?
MO_________ /YR ________
o
YES
o
NO
o
NO
YES
o
NO
HOW LONG WERE YOU UNEMPLOYED BEFORE BEGINNING THIS JOB?
o
YES
o
NAME OF AGENCY: _____________________________________________________________________________________________
PREVIOUS EMPLOYER
*COMPANY NAME TYPE COMPANY? JOB TITLE
CITY / STATE
*SUPERVISOR'S NAME *START PAY $__________ per _________
*PHONE
*SUPERVISOR'S TITLE
*END PAY
$__________ per _________
INCENTIVE/BENEFITS JOB DESCRIPTION *START DATE MO_________/ YR _________
*END DATE REASON FOR LEAVING:___________________________________________________________________ DOES THIS COMPANY USE RECRUITING/STAFFING FIRMS? WERE YOU PLACED BY AN AGENCY? PART TIME?
MO_________ /YR ________
o
YES
o
NO
o
NO
YES
o
NO
HOW LONG WERE YOU UNEMPLOYED BEFORE BEGINNING THIS JOB?
o
YES
o
NAME OF AGENCY: _____________________________________________________________________________________________
PROFESSIONAL REFERENCES ONLY (REQUIRED)
Supervisors & Co-Workers past & present who can comment on your performance & competence
Acquaintances who could use our services
NAME
1. 2. 3.
PHONE NUMBER
1. 2. 3.
NAME
PHONE NUMBER
DOT CODES / SKILL CODES
Use the enclosed checklist to indicate all areas in which you have prior experience and feel confident, including job titles you have held and job-related skills you have used. If you weren't given a checklist, please ask the receptionist to provide one to you that is appropriate for the type of position you are seeking. Completion of the checklist will help us find the best possible match for you.
INTERVIEW WORKSHEET - GENERAL
SO THAT WE WILL NOT DUPLICATE YOUR EFFORTS, PLEASE LIST THE COMPANIES THAT YOU HAVE CONTACTED FOR EMPLOYMENT. COMPANY NAME 1 2. 3. 4. 5. POSITION CONTACT SALARY INTEREST IN POSITION STATUS
INTERVIEW WORKSHEET - CAREER CONSULTATION
1. What is most important to you in terms of your career?
Please give the following questions serious thought. Your candid answers help us counsel you on your career path. _____Benefits _____Money _____Location _____Advancement _____Challenges _____Security
RANK IN ORDER OF PRIORITY FROM 1 TO 6, WITH 1 BEING THE MOST IMPORTANT:
2.
Where do you see yourself in two years:
3. 5.
Can you achieve these goals at your present company?
o
YES
o
NO
4.
Have you discussed this with your supervisor?
o
YES
o
NO
Under what circumstances could your present company retain you?
6.
What do you like about your present or last job / company?
7.
What don't you like?
8.
How long have you been looking for work?
9.
What efforts have you made to find work?
10. Are you a veteran?
o
YES
o
NO
U.S. Military Branch :
Rank:
NO
11. If required, will you relocate within the U.S.? 13. What are your preferred locations for relocation?
o
YES
o
12. If required, will you relocate Internationally?
o
YES
o
NO
14. Where do you prefer NOT to relocate?
15. If required, will you travel as part of your job description?
o
YES
o NO If required to travel, how many nights per week are you willing to be away from home?________
If required, are you willing to travel on weekends?
o
YES
o
NO
APPLICATION Recruiting Source: o o o
Newspaper Employee Referral Customer Referral
RECRUITING SOURCE ID: o o o
Friend/Relative Walk-In Radio
o o o
Television Yellow Pages Magazine
o o o
Direct Mail Trade Show Internet
o o o
Billboard Job Fair Remote Recruiting Event
o o o
State Employment Office School Referral Transfer Employee
o o o
Center of Influence Telemarketing Other
IF REQUIRED, ARE YOU WILLING TO DRIVE AS PART OF YOUR JOB DESCRIPTION?___YES___NO (RECORD YOUR DRIVER'S LICENSE INFORMATION HERE)
Have you ever been convicted of a crime? Felony ___ Yes ___ No Misdemeanor___Yes___No If so give nature of offense, date and sentence.
Describe the felony:
PERFECT CAREER PATH- Describe "your" perfect job.
List Major achievements in current and / or past jobs
1
2
3
AVAILABILITY *REQUIRED *First Date Available Last Date Available *Salary Desired $ _________ / _________ / _________ _________ / _________ / _________ DAYS / per hour OR $ / per year / per year
MON TUE WED THU FRI SAT Minutes one way SUN HOLIDAYS Taxi 1st SHIFT
SCHEDULE OF AVAILABILITY
Place a "X" in the appropriate spaces below to indicate when you are available) 2nd SHIFT 3rd SHIFT AM ONLY PM ONLY NOT AVAIL.
*Minimum Salary Acceptable $ / per hour OR $ *How many hours per week are you willing to work?
*How far are you willing to drive to work each day?
TRAVEL DISTANCE _____________
o
Public
Miles one way
o o
TRANSPORTATION: o Shared Transportation NOTICE REQUIRED:
o o o o
Always Available
o o
Other
WHAT SHIFTS HAVE YOU WORKED BEFORE? Same Day Two Weeks
No Notice Required One Day One Week
o o
o 1st
o 2nd
o 3rd
o AM
o PM
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I hereby affirm that the information I have provided on this form is true and complete. I understand that providing false, incomplete, or misleading information to the company will result in the cancellation of this form and dismissal from or refusal of employment.
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I understand that if I am employed by Ambassador Executive Search, such employment will not be for any fixed period of time and will be on an "employed at will" basis, which means that I or AES are free to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law.
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If offered a job, and if requested by Ambassador Executive Search, I understand that if I am hired, I will be required to provide proof of identity and legal work authorization. I authorize Ambassador Executive Search to investigate my background, obtain information about my character, reputation, personal characteristics, and financial responsibility and other characteristics, in order to evaluate me as a prospective employee, including examination of any and all criminal records and arrests in any state, if applicable, and to verify this information. Upon written request, additional information as to the nature and scope of the report, if one is made, will be provided.
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I authorize Ambassador Executive Search to perform reference checks, which will only be done when AES deems it necessary to further the placement process or to verify information you have given us. Reference information is always kept in the strictest professional confidence.
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I represent and warrant that I have fully read and completely understand the foregoing, and seek employment under the conditions specified. Ambassador Executive Search is an Equal Opportunity Employer, It is our policy to make all employment decisions without regard to age, race, creed, color, religion, national origin, sex, disability, veteran status, martial status or any other protected status in accordance with Federal or State Laws. All employment decisions will be made solely upon the basis of the individual qualifications as related to the requirements of the position to be filled.
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Employment Applications are active for 60 day's. After 60 days you will be required to complete a new application, or update existing application to be considered for employment. EEO/M/F/V/ADA
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Ambassador Executive Search Does Not Guarantee Employment.
*Signature of Applicant:___________________________________________________
*Date Signed:_____________/_______________/_____________