Last Name: First Name:
Address: Phone #: City & Zip: Email: List most recent jobs first
Current/Former Employer Type of Work Length of Job Reason for Leaving 1. Please list 4 things you consider when seeking a career? 2. What are the 3 most important attributes of a highly successful person? 3. What is your ideal work environment? 4. If your previous supervisor was asked to use one word to describe you what would it be? 5. Place a check mark by the 5 characteristics that describe you best. Ambitious Creative
Enjoy Challenges Academic
Outgoing Detail-Oriented
Self-motivated Supportive
Confident Autonomous
Relationship-builder Passive
Process-oriented Thorough
Tactical Strategic
Persistent Independent
Signature: Date: Interview Time: