H/R SEARCH, INC
Chicago’s Premier Placement & Consulting Firm
35 E. Wacker Drive, Suite 1052
Chicago, Illinois 60601
Telephone: (312) 658-1400 Fax: (312) 658-1408
Federal law prohibits discrimination based on age, race, religion, sex or national origin. Information given through your profile
cannot and will not be used for any discriminatory purpose.
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E-mail Address_______________________________________ Social Security #:_________-_________-____________
Previous Address / City, State ZIP
Emergency Contact (not spouse) / Phone
Board How Long?
Rent # yrs. in community
Spouse’s Occupation & Name of Company
Will Relocate: Y __ N __ Immediately? Y __ N __ If not, when?
Will Travel: Y __ N __
Limited / Extensive
Military: Branch of Service: From: To:
Hobbies/ Outside Interests
Name of School
From / To
GPA Graduated? Degree / Title
Major / Subjects
College or University
Position Desired (In Order of Importance)
A. B. C.
Have Resume Y __ N __
Please list three individuals who have knowledge of your personal abilities and character.
(No Former Employers or Relatives)
Other names by which you are known to personal or employment ref