Online Registration
This is a vital step that will save you time and help us serve you well. Your input allows us to better understand the employment needs, interests, and goals specific to you. Accordingly, we are in a better position to be proactive on your behalf and make the most of your valuable time by contacting you only in regard to opportunities that make the most sense for you and your family to consider. Again, as stated in our Privacy Policy, we are sensitive to privacy issues with respect to the use of this information provided to us. "*" = Mandatory. The "tab" key is suggested for moving from field to field.
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| Tell us about yourself: |
| * First Name |
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| Middle Initial / Name |
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| Preferred Name /Nickname |
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| * Last Name |
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| * Street Address |
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| * City |
* State
* Zip Code
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INDICATE BEST CONTACT PHONE NUMBER(S) BELOW
NOTE: WE ARE ALWAYS DISCREET AND RESPECTFUL WHEN CALLING. OUR RECRUITER WILL FIRST IDENTIFY HIMSELF / HERSELF TO YOU, AND THEN ASK IF IT IS A GOOD TIME TO SPEAK. IF IT IS NOT A GOOD TIME FOR YOU TO SPEAK, YOU WILL LIKELY BE REFERRED TO AN E-MAIL COMMUNICATION AND INVITED TO RETURN THE CALL AT YOUR EARLIEST CONVENIENCE. |
| * Primary Contact Phone:
Type of Phone?
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| Generally Preferred Windows of Time to Accept a Call at the Primary Contact Phone:
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| Other Contact Phone:
Type of Phone?
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| Generally Preferred Windows of Time to Accept a Call at the Other Contact Phone:
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| * Primary E-mail address:
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| NOTE: Many companies randomly review employee e-mail. We recommend that you use a personal e-mail account or a free account that you can obtain from yahoo.com, hotmail.com, or many other places. |
| Do you monitor the inbox of the above e-mail address at least once daily?
yes
no |
| * Have you ever been convicted of a felony, convicted in a military court martial, or dishonorably discharged from the military?
yes
no |
If yes, please explain:
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| * Is it legal for you to work for any employer in the United States?
yes
no |
If sponsorship is required, please explain:
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| Tell us about your employment: |
| * Are you presently employed full-time?
yes
no |
* Current Employer (if presently employed)
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* Current Job Location (if presently employed)
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| * Current Annual Salary $
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| * Bonuses (sum of most recent 12-month period) $
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* IF in the past 10 years, you have been employed with any employer for a period of less than 3 years, list that specific employer’s name and a brief explanation of your reason for leaving. Note: Your resume should include starting and ending dates in a month/year format.
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* Primary motivating factors for considering other employment at this time?
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* Time frame in which you seek to make an employment change?
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| * If you leave your current position, would your employer be surprised?
yes
no
unsure |
| * Do you anticipate a counteroffer from your present employer?
yes
no
unsure |
If you do NOT anticipate a counteroffer, please know why. What are your reasons?
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| NOTE: Counteroffers occur much more often than many professionals realize. Many employers use them as a means to minimize interruption of work flow and to buy enough time to hire someone else. A super-majority of professionals who accept a counteroffer are not employed with the same employer one year later most often leaving for the same original reasons; or having demonstrated a willingness to leave, they become marked and on the short list in case of downsizing, reorganization, etc. |
| How long of a notice period would you need to give your current employer?
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| Tell us about your skills and interests |
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| Bachelor's
Major
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| Master's
Major
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Other:
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| * Professional Certifications |
Check all that apply:
CPA
CMA
CCM
CIA
CISA
CFA
CBA
CVA
ABV
MCBA
ASA |
Other (Describe)
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| * Experience |
| Public Accounting:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| National Public Accounting Firm Exp:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| Corporate Financial Accounting:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| Non-Profit/Government Accounting:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| Cost Accounting:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| Audit:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| Tax:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| Supervisory Experience:
0-1 years
1-2 years
2-5 years
5-10 years
10+ years |
| How many people have you supervised?
0-1 people
2-5 people
6-10 people
11-25 people
26+ people |
| In what languages can you read, write & converse?
English
Spanish
French
German
Japanese |
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Other (Describe)
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* Primary Services Expertise
(Check all items listed below for which you have some expertise and professional interest) |
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| * Industry Specializations (Check all items listed below for which you have some expertise and professional interest) |
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Agriculture / Agribusiness |
Litigation Services |
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Auto Dealerships |
International Business |
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Closely-held Companies |
Labor Organizations / Trade Associations |
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Communications / Broadcasting |
Large Retail |
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Construction |
Manufacturing |
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Defense Contractors |
Municipalities / Counties / Districts |
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Educational Institutions |
Natural Resources: Oil, Gas, Mining, etc. |
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Entertainment / Recreation |
Not-for-Profit Organizations |
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Financial Services: Banks |
Nursing Home / Senior Housing |
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Financial Services: Broker / Dealers |
Pension / Employee Benefit Plans |
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Financial Services: Credit Unions |
Printing / Publishing |
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Financial Services: Investment Banks |
Professional / Amateur Sports |
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Franchising |
Professional Employer Organizations |
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Gaming |
Professional Practices: Architectural, Dental, Engineering, Legal, Medical, Veterinarian, etc. |
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Governmental Entities: State and/or Local |
Real Estate |
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Government Contracting
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Restaurants |
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Health Care / Medical Billing
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SEC-regulated Companies |
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High Technology
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Service Organizations |
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Insurance / Statutory: Other Specialty Insurance |
Software Companies |
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Home Builders |
Telecommunications |
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Hospital |
Textiles |
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Hospitality / Travel |
Transportation: Aviation, Rail, Shipping, Trucking, etc. |
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Housing: HUD and Section 42 |
Utilities |
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Import / Export |
Waste Management / Recycling |
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Insurance / Statutory: Life/Health |
Wholesale Trade |
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Other (please describe)
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Tell us about your most memorable work-related achievements:
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Tell us about the best and the worst boss you ever had:
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How would your co-workers describe you?
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| Tell us about your ideal next job: |
* Describe the ideal job for you. Include factors like industry, specialty, position, duties desired, and other attributes.
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| * To what extent are you willing to travel?
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| * Are you willing to consider relocation?
yes
no
maybe |
If you answered yes or maybe, indicate in order of preference any specific geographical areas within the United States where you would seriously consider relocating, plus any other key thoughts you have on relocation. Example: Do you have a strong preference for being in or near a large city, or would you rather relocate to a medium or small city/large town environment?
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If you are seriously open to relocation, do you own real estate or have an extended lease that must be addressed in order to relocate?
yes
no |
| (Note: Most lessors are willing to terminate your lease obligation, especially if you communicate your need early and you demonstrate an openness to negotiate a reasonable settlement, such as surrendering one month’s rent in order to give the lessor time to find another tenant. Circumstances vary and depend somewhat on local market conditions.) |
If you answered yes to the above question, do you believe that actually selling the real estate or negotiating a lease settlement could pose a significant problem to you being able to relocate within two months of accepting an offer of employment?
yes
no |
To what extent would you require paid relocation assistance in order to make a relocation move?
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If willing to relocate, are there any other people who have employment or some other factor that would prevent your ability to actually relocate?
yes
no |
* Based on the cost-of-living in your current location, what total annual compensation
(including salary, bonus, etc.) are you looking for?
$
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* What employment benefits are most important to you?
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* Just so that we do not inadvertently exclude you from considering an otherwise ideal position, what is the minimum annual compensation you would consider for a good opportunity? In other words, you are telling us to NOT present you with anything having a starting annual compensation of less than:
$
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* List other types of resources that you are using in your job search
(recruiters, job boards, classified ads, etc.)
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List any companies / firms where you are aware your resume has
been submitted within the past six months.
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| NOTE: Countless professionals make Belcher & Associates their first and often only choice among employment search firms. However, if you have already contacted potential employers, this list simply allows us to make wise use of our time for you, and avoid consideration / duplication of your earlier employment contacts. |
Please click the Submit button below to complete the submission process. If you provided us with an E-Mail address earlier, within a few minutes of your submission, we will automatically e-mail a confirmation receipt plus other information which may be helpful to your job search. Click the Submit button below in order to complete the registration process.
All of my Information above is Accurate and Complete
Please Note:This form can not be submitted unless this box is checked.
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