Jackson McCarthy & Associates
Your Name: Today’s Date:
Phone/Cell: E-mail:
Compensation:
1. Your current – base bonus
2. How much do you hope to make?
3. When was your last raise?
Where do you live?
1. What town do you live in?
2. How far will you drive each way to work?
3. Will you relocate?
What do you want to do?
1. Stay in Public Accounting?
2. Move to private industry?
Why do you want to move at this time?
Please be specific:
When do you want to change jobs? Date __/__/__
Describe your ideal position? Please be specific:
What is your long term goal(s)?
Please provide the names of 3 references. One reference should be a manager or supervisor at your last employer”
Name: ________________________ Title: ________________________ Employer: _________________________
Name: ________________________ Title: ________________________ Employer: _________________________
Name: ________________________ Title: ________________________ Employer: _________________________
What is the best time to reach you? Before ___ and after ____
Please select best way to reach you: Cell Phone ( ), Email ( ). Be sure to provide information above.
How many days notice would you need in advance of an interview?
Are you presently working with any other recruiters?
1. Yes, how many? 1. 2. 3.
2. No
Sean McCarthy sean@jacksonmccarthy.com Direct: 818-389-1876 www.jacksonmccarthy.com