Candidate Submission Form

Thank you for submitting your profile to R.V. Bertrand Consultants.
All fields marked * are required to submit the form.

While only the top few fields are required, the more complete your information, the better we can effectively match you to an opportunity.  Since we represent the interests of our clients, we may not be able to respond to all inquiries and resume submittals.  All responses are held in strictest confidence, and will not be forwarded to a client without prior contact with the candidate.



Today's Date: 03/04/2010
Personal Information
* First Name:
Middle:
* Last Name:
Prefix:
Suffix:
(Multiple selections allowed)
* Functional Discipline:
Marital Status:
 Married
Common-Law
Divorced
Widowed
Engaged
Single
Date of Birth (Month/Day/Year):

Resume Cover Letter and/or Note to Recruiter

You may cut and paste to the text box above.

You may cut and paste to the text box above.

Contact Information
* Address:
* Address (line 2):
* City:
* State or Province:
* ZIP/Postal Code:
Country:
Please include country code and city code for all phone numbers input below
* Home Phone:
Home Office Phone:
Home Office Fax:
* Office Phone (primary):
Office Phone (secondary):
Office Fax:
Mobile Phone:
Pager:
e-Mail (primary):
IM (primary):
e-Mail (secondary):
IM (secondary):

Current or Most Recent Employment
* Company Name:
Industry:
Parent Company Name:
* Annual Sales ($US):
* Number of Employees:
Company Assets ($US):
City:
State or Province:
Country:
* Position Title:
* Functional Discipline:
Employment Status:
Date Started (Month/Year):
Date Ended:
(Leave Blank if Current)
* Annual Salary:
Annual Bonus:
* Total Annual Cash Compensation:

Previous Employment
* Company Name:
SIC Code:
Parent Company Name:
* Annual Sales ($US):
* Number of Employees:
Company Assets ($US):
City:
State or Province:
Country:
* Position Title:
* Functional Discipline:
Employment Status:
Date Started (Month/Year):
Date Ended:
(Leave Blank if Current)
* Annual Salary:
Annual Bonus:
* Total Annual Cash Compensation:

Previous Employment
* Company Name:
SIC Code:
Parent Company Name:
* Annual Sales ($US):
* Number of Employees:
Company Assets ($US):
City:
State or Province:
Country:
* Position Title:
* Functional Discipline:
Employment Status:
Date Started (Month/Year):
Date Ended:
(Leave Blank if Current)
* Annual Salary:
Annual Bonus:
* Total Annual Cash Compensation:

Previous Employment
* Company Name:
SIC Code:
Parent Company Name:
* Annual Sales ($US):
* Number of Employees:
Company Assets ($US):
City:
State or Province:
Country:
* Position Title:
* Functional Discipline:
Employment Status:
Date Started (Month/Year):
Date Ended:
(Leave Blank if Current)
* Annual Salary:
Annual Bonus:
* Total Annual Cash Compensation:

Other Employment
Details:

Highest Level of Academic Achievement
* Name of School / Certifying Agency:
City:
State or Province:
Country:
*Degree/Certification (primary):
Major Field of Study:
Completion Date (Month/Year):
* Name of School / Certifying Agency:
City:
State or Province:
Country:
*Degree/Certification (additional):
Major Field of Study:
Completion Date (Month/Year):
Other Education:

Additional Information
Willingness to Travel:
# Years of Total Work Experience:
Willingness to Relocate:
# Years of Work Experience in Specialty:
Countries in Which You
Can Legally Work:
*Desired Income:
How Soon Would You Like To Start in a New Position:
Hobbies and Interests:
Community Involvement:
Able & Willing to Work in
Which Countries?
(Hold down [Ctrl] key to
make multiple selections):
 Other Countries:
Primary Language:
Other Languages
(Hold down [Ctrl] key to
make multiple selections):
 Other Languages with 75% Fluency or Better: