Please fill out the following form.   This will assist us in finding you the perfect job.

Position Applying for
(if applicable)
First name 
Last name 
Street address 
City 
State 
Zip/Postal code 
Country 
Work Phone 
Home Phone 
Cell Phone 
Home E-mail 
Work E-mail 
Other than English, list any languages you speak 
What is your working status in the U.S.?
   

TASC has been a member of IPA since 1990.  IPA is a networking group of search firms who collaborate on helping candidates uncover employment opportunities in their disciplines.  Each IPA firm has its own client base, with intimate knowledge of their client companies and their needs.  Our IPA affiliates may be aware of opportunities that match your skills.  TASC will remain as your IPA contact firm throughout your search.  There are NO FEES OR OTHER CHARGES for this service.
   
Please indicate if you would like to use this service:   Yes No
   

Employment Information

Are you currently employed?   Yes No
If No, what was your last day worked?
Current/most recent employer  
Position Title 
Dates of Employment
What do they manufacture/sell?  
They are a division of... 
If you are unemployed, why did you leave your last position?
If you are still employed, why are you considering an employment change?
Are there any companies we should not contact when finding you a position? 
What is your Current Salary?  
What is your Desired Salary?  
What is your Minimum Salary?  
List other types of compensation or benefits, i.e. Bonuses, Overtime...
Would you consider working on a contract basis? Yes No
 
In order to avoid conflicts, please list any companies with locations that you have already been in touch?
What types of opportunities interest you?
Do you have a non-compete clause? Yes No
If yes, please describe
 
Are you responsible for reimbursement to your current employer for relocation or educational expenses if you leave before a certain date? Yes No
If yes, please give details

Education Information

What is your First degree?
Select the type of degree 
Institution Name 
Year of completion 
GPA 
What is your Second degree? 
Select the type of degree 
Year of completion 
Institution Name 
GPA 
List any licenses/Certifications you have. Examples - CPA, ASP, CMA, CPIC, CSP, SPHR, PHR, CPIM, PE, CEBS, CCP, CPM   

Relocation Information

Are you willing to relocate? Yes No
   
Are there any special needs that might impact your job change - i.e. employment for spouse, schools for children, etc.?
   
Select your relocation preference
   

Select any other places you would relocate:

Open to Any  (or select specific locations below)
Alabama Alaska Arizona
Arkansas California Colorado
Connecticut Delaware DC-Washington
Florida Georgia Hawaii
Idaho Illinois Indiana
Iowa Kansas Kentucky
Louisiana Maine Maryland
Massachusetts Michigan Minnesota
Mississippi Missouri Montana
Nebraska Nevada New Hampshire
New Jersey New Mexico New York
North Carolina North Dakota Ohio
Oklahoma Oregon Pennsylvania
Rhode Island South Carolina South Dakota
Tennessee Texas Utah
Vermont Virginia Washington
West Virginia Wisconsin Wyoming
Alberta British Columbia Manitoba
New Brunswick Newfoundland NW Territories
Nova Scotia Ontario Prince Edward Is.
Quebec Saskatchewan Yukon
     
Is there anything else we need to know about relocation?
(i.e. metro vs. rural)

References

Reference 1

  
  First name
  Last
Relationship
Phone
  Email
   

Reference 2

  
  First name
  Last
Relationship
Phone
  Email
   

Reference 3

  
  First name
  Last
Relationship
Phone
  Email

 

Your Resume

What other background is important to know about you that is not contained on your resume?

Please Note:  Prior to attaching your resume, please rename it as follows:  LastName FirstName.doc  (example:  Doe John.doc)

Attach your resume here. (Files may be .doc, .txt, .rtf)

 

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Telem Adhesive Search Corp., P.O. Box 656, Owings Mills, MD 21117
Ph: 410.356.6200    Fx: 410.356.5189   Info@telemadhesivesearch.com