A Technical Recruiting Organization Serving Medical Product Companies

Resume Data Sheet Form

Please Send Copy of Resume to email address

Email: raybaltis@baltis.com
Candidate Information:
First Name:
Last Name:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Alternate Email Address:

Employment Information:
Current Salary: Base & Bonus:
Stock Options & Other Incentives:
Current Employer Name:
Products Worked On:	1.
2.
3.		Include copy of resume
Quantify Your Accomplishments for Current Employer (time or money savings or earnings):

Previous Employer Name:
Products Worked On:	1.
2.
3.
Quantify Your Accomplishments for Previous Employer (time or money savings or earnings):

Reasons for Present Job Change:

Computer Skills:
1.		4.
2.		5.
3.		6.
Describe Management Style:

Relocation Preferences:

Areas you would like to move to:
1.
2.
3.
Areas you would not like to move to:
1.
2.
3.

Relocation Information: (We ask for the following information because it may relate to ease of relocation.)
Referral Source:
Residency Status:
Homeowner/Renter:
Married/Single:
Spouse Employment:

Additional Comments: