CLARENCE RICHARD COMPANY 3624 SUSSEX PLACE , MINNETONKA, MN 55345

TOLL FREE 800-372-7731 FAX 612-938-3304 email web WWW.croc.net

Candidate Name______Title______SSN______Address______City______

Home phone______Work phone______Fax______Home-Own___Rent__

HOME: what days and times , if any, may we contact you there? ______

WORK: what days and times , if any, may we contact you there? ______

Position Wanted ______Are you sending us a resume’?______

Job duty expectations at:

spring startup______

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construction season______

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winter shutdown______

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Salary/Wage Range______

What kind of vacation or lay off time is important to you?______

______

How many mile radius from home will you travel for work?______Are you willing to relocate?_____

If so, where is desirable?______

Where are you not willing to relocate to?______

Starting date; desired when?______What is earliest acceptable starting date?______

Education :High school______location______If graduated, when?___

Technical school______location______years____If graduated when?___

Course title______, course description______

Technical school______location______years____If graduated when?___

Course title______, course description______

College______location______years____If graduated when?___,

Course title______, course description______College______location______years____If graduated when?___,

Course title______, course description______

What pieces of equipment or tasks are you certified, qualified or proficient at doing? ______

______

______

Work history starting with most recent employer

1)  Employer______, Office location ______May we contact them?_____

If no, why? ______

If yes, write in contact name______, Title______, Phone number______

Start salary/wage$______per____End Salary/Wage $______per____Start Date_____End____

Job description when hired______

______

Job description before leaving______
______

What did you like about the job and people?______

______

What did you not like about the job and people?______

Why did you leave?______

2)  Employer______, Office location ______May we contact them?_____

If no, why? ______

If yes, write in contact name______, Title______, Phone number______

Start salary/wage$______per____End Salary/Wage $______per____Start Date_____End____

Job description when hired______

______

Job description before leaving______
______

What did you like about the job and people?______

______

What did you not like about the job and people?______

______

Why did you leave?______

______

3)  Employer______, Office location ______May we contact them?_____

If no, why? ______

If yes, write in contact name______, Title______, Phone number______

Start salary/wage$______per____End Salary/Wage $______per____Start Date_____End____

Job description when hired______

______

Job description before leaving______
______

What did you like about the job and people?______

What did you not like about the job and people?______

Why did you leave?______

4)  Employer______, Office location ______May we contact them?_____

If no, why? ______

If yes, write in contact name______, Title______, Phone number______

Start salary/wage$______per____End Salary/Wage $______per____Start Date_____End____

Job description when hired______

______

Job description before leaving______
______

What did you like about the job and people?______

What did you not like about the job and people?______

Why did you leave?______

5)  Employer______, Office location ______May we contact them?_____

If no, why? ______

If yes, write in contact name______, Title______, Phone number______

Start salary/wage$______per____End Salary/Wage $______per____Start Date_____End____

Job description when hired______

______

Job description before leaving______
______

What did you like about the job and people?______

What did you not like about the job and people?______

Why did you leave?______


CANDIDATE CRCO RECRUITERS SERVICES EMPLOYMENT

DEAR PROSPECTIVE EMPLOYMENT CANDIDATE:

Welcome to an industry of many challenging opportunities. Along with the fascination and personal growth that undertaking opportunities have come risks of many types.

You must understand the agreement you make with a potential employer is between you and the employer only. Clarence Richard Company (C R Co.) shall not to be liable for any misunderstandings , misdeeds, misrepresentations between employer and employee. Any agreement between them concerning compensation and expenses of any type is no concern to Clarence Richard Company (other than Employer Paid Fee) and it is agreed that C R Co. shall not be held liable for any damages incurred by either party.

It is to your benefit to have in writing any and all important terms of your agreement signed and dated by both you and your future employer. We find this will help both parties have a more lengthy and successful relationship.

We look forward to helping you shop for opportunities to your future.

______/____/___

AGENT DATE

I, the prospective employment candidate have read and understand the above and assume all risks with future employment opportunities furnished by Clarence Richard Company.

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Print Name Sign Name and Date if you agree to the above