SUBJECT LINE: SUBMISSION / CANDIDATE NAME / CLIENT NAME / JOB TITLE / JP# (JOB ID) / LOCATION (REMOTE OR

CITY & STATE ABBREVIATION)

Candidate Summary:

 Notes

Basic Details
Full Legal Name:
DOB (MM/DD):
Last 4 SSN#:
Security ID:
Actual Pay Rate:
Bill Rate:
Is candidate able to accommodate a local on-site interview?
Work Authorization / Visa status:
Best #:
Email Address:
Current Address & Commute:
Highest Completed Education:
Availability to Start: 
Availability for Interview: 
Upcoming Events / Vacations: NEED SPECIFIC DATES!
Source of Resume:
Expected Pay Rate:

Authorization Required
Did you add content to the candidates resume?

Interviews
In the last 2 weeks have you conducted any interviews in which your awaiting feedback on? If so, please answer the
following.
1. How many?
2. What rounds are they in?
3. How many are for Perm and/or Contract?
4. How does the pay compare to this? 

In the next 2 weeks do you have any interviews scheduled?

1. How many?
2. What rounds are they?
3. How many are for Perm and Contract?
4. how does the pay compare to this?

Screening Questions
1: DRUG TEST: 
 The client requires all candidates to successful pass a DT screen before starting.
 Are you comfortable with taking a DT?
2. EMPLOYMENT CHECK:
 In the event the BG vendor can’t verify your employment, can you provide supporting documents (W2 or
Paystub) for employers from 2015 – Present?
3. EDUCATION VERIFICATION:
 In the event the BG vendor can’t verify degree, do you have transcripts and/or copy of degree of their highest
education as mentioned on the resume?
4. STATE & COUNTY VERIFICATION:
 The client requires a successful completion of criminal checks.  If you feel there is anything we should keep an
eye out for, please feel free to let us know.

Candidate currently working: If yes, answer below else just mention N/A (Please make sure it matches with the
attached resume)
Working Full Time / Contract:
Reason for Change:
How does this pay compare to their current role?
Current Pay:
Notice to be Served:
Are they getting any benefits? Please mark below which benefits they are getting.
 Health: yes
 Dental:
 Vision:
 PTO:
 Vacation: yes
 401K:

Previously Worked for Client: If yes, answer below else just mention N/A
FTE / Contract:
Duration With Dates:
Ex Manager Name:
Department:

If Relocating
Have they relocated before for a job/assignment?
Are they currently renting?
If they are renting, is there a penalty for breaking their lease?
 How months are left on the lease?
Do they own their own home?
 If so, what will they do with their home?
Are they relocating by themselves?
Are they aware there will be NO moving and/or housing assistance?
How long from an offer will it take for them to relocate?
May 2022
Degree
Comfortable
yes
Raegan Guillory
no interviews
ok
you are rental
apr-10
1156
no
usc