Thank you for taking the time to complete the IMPACT Search and Placement Online Application

The application contains two important sections:
1) Personal, Educational and Employment Information
2) Attaching or Uploading Your Resume

It is vital that you complete both sections as thoroughly as possible. We can not effectively process your application without both sections being complete.

Please follow the directions as stated at each section. Leaving sections blank will only slow our process. Items in RED and marked with an asterisk (*) are REQUIRED.

To help us fulfill your request and receive employment information from IMPACT Search and Placement LLC via email please add HedHunt1@aol.com and YourHeadhunter@aol.com to your Address Book or Safe List. Not sure how? Follow these instructions

Information obtained from this form is used only in the pursuit of placing candidates in employment positions.

IMPACT Search and Placement, LLC strictly adheres to E.O.E. Policy guidelines. If you find any questions objectionable please disregard that question. We only ask for this information to aid in a successful placement.

 
Personal Information
First name *
Last name *
Address line 1 *
Address line 2
City *
State *
Zip *
Country *
Home phone *

(example: 123-456-7890)
Mobile phone
(example: 123-456-7890)
May we contact you at work *

Yes No
Work phone
(example: 123-456-7890)
Email address *

(example: johndoe@somedomain.com)
Marital Status *
Married Single Partnered
IF Married or Partnered do they work outside the home?
Yes No
IF Yes, Type of work
Please let us know your spouse's occupation so that we will be prepared to help them secure employment if needed
Do you have children in school?
Yes No
If so we will be happy to research schools when relocation is involved.
Your Residence
If you should move or change contact numbers please provide the name of a person that will know how to contact you.
Name *


Phone *
U.S. Citizenship *

Yes No Visa Type
Education
Institute/University
(example: XYZ University)		 Degree
(example: Master's degree)		 Primary subject
(example: Accounting)		 Year
(example: 1992)
References
You may fill all or none of the rows below; ensure that no fields are left empty per filled-in row
Name
(example: John Doe)		 Phone
(example: 123-456-7890)		 Email address
(example: johndoe@somedomain.com)
Miscellaneous
Briefly explain Products or Processes that you have worked with.
Date of Availability*
(MM/DD/YYYY)
[ Choose date from a calendar ]
Reason for Change *
Current or Last Salary *

(example: 45,000)		 Bonus
(example: 5,000)
Minimum Acceptable Salary *

(example: 50,000)
Relocation Preferences *
PLEASE CHOOSE ONE OF THE FOLLOWING ONLY (1,2 or 3)
1.) Live or relocate to following CITY or commute to the following ONLY.
2.) I am willing to relocate ANYWHERE in the U.S.
3.) I am ONLY willing to relocate to the STATES below.
Alabama Alaska Arizona Arkansas California
Colorado Connecticut Delaware District of Columbia 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