TOP New York

First

Last

Date:

Internal Use Only

Middle

Mr./Ms.

Consultant (

)
Temp

Street
City

State

Zip

YN

Visa Type: ______________________

Overtime YN

Expired on: (

DL

Salary: ____________RL :_____________

YN

CarCommuteYN

Tel: (

Work:(

Admin ( Jr Sr ) Sales ( Jr Sr ) Finance ( Jr Sr ) Logistics

E-mail:

Accounting (Jr Sr CPA)

Are you willing to relocate? Yes No

Creative

If yes, where

Do you currently have an eligible work permission in the U.S.?

/

IT

Engineer

Other (

Do you have Social Security Number? Y / N

Any expire date:

NPO

Pharma/Bio

Y/ N
Preferred Industry:

Title:

PLEASE FILL OUT EVEN IF RESUME IS SUBMITTED (PRINT LAST POSITION FIRST)

Firm Names, Address &

Phone Number

Dates
From

To

Names of Personnel /

Type of Business/

/ Office Manager & Your

Position & Duties

& Immediate Supervisor

Salary

Reason for

Annually

Leaving

Weekly

Mo/Yr

Mo/Yr

Start / Leave

Mo/Yr

Mo/Yr

Start / Leave

PC: Word / Excel / Power Point / Access / Accounting Soft / Others (

List the most important things you are looking for in your new position.

Language Skill
Speak

Education Name of School

Yrs. Att.

Read

Write

Year of
Graduated

Note:

High School
College

Major/Degree

Additional Education

Major/Degree

IN ORDER TO AVOID DUPLICATION, PLEASE LIST PREVIOUS INTERVIEW. (PLEASE INDICATE POSITION INTERVIEWD FOR)
COMPANY NAME

1.

3.

2.

4.

PLEASE LIST COMPANIES (INDUSTRIES) WHICH YOU DO NOT WANT TO APPLY.

Company Name

1__________________________________________________

3.________________________________________________

2__________________________________________________

4 _______________________________________________

PLEASE LIST TWO EMPLOYER REFERENCES:

CO. NAME

PHONE NO.

CITY, STATE

REFERENCE

POSITION

1.

2.

How did you learn about us?

Newspaper (Name:

) Web (

) Referral (

) Other (:

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references (with the exception of present

employment). We need your approval now to verify your references in the future if required. With your consent, we can

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Date

Applicants Signature

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