LOGO Candidate Information Form

Thank you for taking the time to fill out our short form, so that we can most effectively present your credentials to our client.  This will also help usbecome more knowledgeable of your background and interests. We all dislike filling out forms, so we have diligently tried to make this as painless as possible.  Therefore, a lot of this is point and click.  We promise to give our best effort in making the next five minutes you spend on this form time well spent.

Please provide the following contact information:

First Name (* required)
Middle Initial
Last Name(* required)
Street Address
Address (cont.)
Zip/Postal Code
Home Phone
Work Phone
Mobile / Other
E-mail(* required)

Degree 1

Actual Degree Name (i.e.  BSME, BSEE, etc.):
Institution Name:
Year of Graduation:
-- yyyy
Overall GPA:

Degree 2(If applicable)

Actual Degree Name:
Institution Name:
Overall GPA:
Year of Graduation:
-- yyyy

Degree 3(If applicable)

Actual Degree Name:
Institution Name:
Overall GPA:
Year of Graduation:
-- yyyy
Certifications (P.E., Journeyman, CPA, etc.)

Are you currently employed?

Yes No

If no, when was the last day you worked?

-- mm/dd/yy

If no, when was the last day you worked?

-- mm/dd/yy

Your Current/Last Employer:

Your Current/Last Title:

Company Product or Services

Years of Experience:


Please scroll and highlight the appropriate amount representing your current or last base salary, rounded off to the closest thousand.  This should not include bonus or other additional income. This type of income can be accounted for in the next section.

Additional Salary information(Please do not use $ signs, decimal points or commas)

Actual Base Salary         Bonus( if applicable)

Desired Salary         Minimum Salary

Relocation requirements:

If we may suggest, there are usually two levels to express acceptable location of future employment:

1)Those locations that you"Will consider"for the ideal job

2)Those locations that you"Prefer"

It is always in your best interest to keep your "Will consider" locations as broad as possible, and then be selective in choosing which individual positions you move forward to the next level of your search,(ie. phone conversation, interview, offer, etc.)

Please select the states you "Will consider"as relocation options for good opportunities and fill in specifics in the"Preferred Locations"box. You may select as many as you desire. The more open you are, the more likely a good opportunity will be available.  (Check all boxes that apply)


Preferred Locations:

Please list the jobs or positions you feel qualified for (i.e. Design Engineer, roject Manager, Senior Technical Lead, Manufacturing Engineer)

Reason for job search:

Lay off - Downsized
Advancement opportunities
Looking for more challenges
More money
Starting career
Changing career

Please list the jobs or positions you feel qualified for (i.e. Design Engineer, Manager, Senior Technical Lead, Manufacturing Engineer)

Please choose one (1) industry from the list below, as he primary area most closely associated with your background.  You will be asked to chose additional secondary industries in the following step.


Please choose from the following list other industries that you would classify as secondary in your background, not as strong as your choice above, but still are areas you have been exposed to. (Check all boxes that apply)


You may find yourself wanting to respond to the next few questions with some of the same terms.  This is not a problem,since companies in today's business world classify skills, processes and industries almost interchangeably and vary dramatically from company to company.  We encourage you to use the terms you feel most comfortable with.

With what PROCESSES are you experienced? (Metal fab, Injection Molding, Machining, Stamping, Chemical Batch Processes, etc.)

What particular SKILLS do you have that may be of value to a future employer? (Design, Product Development, Process Improvement, Manufacturing Supervision, etc.)


What PRODUCTS are you experienced with? (Circuits, Valves, Plastic Containers, Air Conditioners, Motors, Automotive Parts, etc.)


Have you ever managed people?

Yes No

If so how many at one time?

Open to travel?

Yes No

Percentage of travel open to:


May we utilize all of our extensive resources including the IPA(Inter-City Personnel Association) and Top Echelon networks of affiliates? (There is no obligation and absolutely no expense to you for utilizing any of our resources.)

Yes No

Citizenship (US):

Yes No

If no, what is your Visa status:

Expiration of Visa:

-- mm/dd/yy


Please select the appropriate status of your current

Number of people to relocate if necessary:


Please use this space to give us any additional information that you feel would be helpful to us in finding the ideal opportunity for you.  This information should include things like career accomplishments, areas of expertise, additional training or certifications, etc.

Please email your resume to

Copyright 2002 Clifton Johnson Associates. All rights reserved.
Revised: 7/2015