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Career Planning Guide
 
Name:  Home Phone: 
Email:  Work Phone: 
    Mobile/Pager: 
       
What are you looking for in your next position?
 
What is your TOTAL compensation now? Base:
Commission or Bonus: +Options:
 
Other Benefits?
 
What is the minimum compensation you would accept for the right opportunity?
 
What would make you happy (compensation)?
 
Are you willing to Relocate? Are you willing to travel?
Yes No Yes No
Have you discussed relocation with your family? Nights per week:
Yes No 1-2 2-3 4-5
Areas to which you would NOT relocate?  
 
Reasons for considering a change:
 
Have you considered your response in case your current employer
would make a counter offer if you were to resign?
 
Companies you have interviewed with in the past 12 months and status (list):
 
Companies you would like to work for:
 
Companies for which you would NOT like to work for:
 
Work Status: You must specify your work status, please check all that apply:
 
 I am authorized to work in the United States for any employer.  
 I am authorized to work in the United States for my present employer only.
 I require sponsorship to work in the United States.
 
 
List Three Professional References:
     
Name:   Title:  
Address:   Relationship:  
Telephone:      


Name:   Title:  
Address:   Relationship:  
Telephone:      


Name:   Title:  
Address:   Relationship:  
Telephone:      


FCRA DISCLOSURE

In working with you on career opportunities, we may obtain information about your experience and background. The information may include materials, records, and written and verbal reports relating to prior job experience and performance, education, credit history and rating, driving record, and criminal and civil litigation record, if any. It may also include results of tests and assessments administered by you or others. We may provide this information to prospective employers. In accordance with the Federal Fair Credit Reporting Act (FCRA) you have the right to request that we disclose to you the "nature and substance" of all information about you in your file.

 
Check to Agree:
 

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The Lake City Group
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