General Information Form

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Personal Information

First Name  Middle Initial  Last Name 

Street

City State Country

Postal Code

Home Phone Office Phone

Languages
1- 2-

3- 4-

Education

Date Graduated

Education Field General Commercial Technical BioMedical BioChemical Medical

Citizenship 1-  2-  3-

Employer Information

Company

Parent Company

Position

Function ADM Administration, Office Mgmt ASS Association & Trade Mgmt BCC Banker Commercial/Credit BCU Share, Bonds, FX BIV Investment, M & A BTR Portfolio & Trust BUY Purchasing CMR Construction/Project Manager CON Consultant DIS Distribution DOC Medical, Vet., etc. - All ECO Economist EDP MIS Management EDU Education Mgrs. & Professors FAL Finance Overall FAU Auditor FCA Chief Accountant FCT Controller FPL Planning FTR Treasurer FTX Tax GMA GM/ Pres. Overall GMC GM - Consulting/Misc. GME GM - Engineering/Tech GMF GM - Finance GMH GM - HR GMM GM - Marketing GMP GM - Production GOV Government Mgmt - All Types HLR Labor Relations HRA HR - Overall HRC Compensation/Benefits HRR Recruiting LEG Legal MAD Advertising MAL Marketing - Overall MEI Export/Import MPT Product Management MRS Market Research MSL Sales MSV Mktg. Services - All Types NOP Non Profit Management PAL Manufacturing - Overall PDN Line Pdn Management PLA Strategic Planning PMT Maintenance PPL Production Planning PQC Quality Control PRA Public/Government Relations PSV Pdn Services - All Types RND Research & Development SCH Executive Recruiters TRD Trading

Industry Advertising AGR Agriculture ASS Associations/Trade Groups AUD Auditing BKC Banking Commercial BKI Banking Investment BKP Banking Private BKS Banking S & L CBA Consumer Apparel, Footwear CBB Consumer Beverage CBC Consumer Cosmetics CBE Consumer Electronic CBF Consumer Food CBM Consumer Miscellaneous CBR Consumer Branded CBT Consumer Toys, Bicycles, Sports CHM Chemicals - Raw Materials COE Construction Equipment CON Consulting COS Construction Services EDP Hardware & Software ENG Engineering Firms FLY Aviation All FSC Security & Commodity Brokers FSL Financing, Credit & Leasing GVT Government HIT High Technology HLT Healthcare Equipment HOS Hospital/Nursing Management HOT Hospitality, Hotel, Timeshare, etc. INE Import & Export INS Insurance MAH Manufacturing Heavy MAL Manufacturing Light MCH Machinery MNG Mining NON Non Profit OFC Office Equipment OIL Petroleum - All Types PAP Paper & Packaging PHA Pharmaceutical & OTC PLS Plastic Products PRI Printing & Publishing PWR Power & Energy REC Real Estate Commercial REP Real Estate Private RES Research Institutions RTL Retail RUB Rubber SCE Shopping Center - Mgmt & Lease SCH Executive Search SHP Shipping TNS Transportation - All Types TNT Telecommunications - All Types TRD Trading UTL Public & Private Utilities VEH Vehicles & Parts - All Types WHS Wholesale

Location Country

Start Date  To

Compensation ($US 000's)

Previous Employer Information

Company

Parent Company

Position

Function ADM Administration, Office Mgmt ASS Association & Trade Mgmt BCC Banker Commercial/Credit BCU Share, Bonds, FX BIV Investment, M & A BTR Portfolio & Trust BUY Purchasing CMR Construction/Project Manager CON Consultant DIS Distribution DOC Medical, Vet., etc. - All ECO Economist EDP MIS Management EDU Education Mgrs. & Professors FAL Finance Overall FAU Auditor FCA Chief Accountant FCT Controller FPL Planning FTR Treasurer FTX Tax GMA GM/ Pres. Overall GMC GM - Consulting/Misc. GME GM - Engineering/Tech GMF GM - Finance GMH GM - HR GMM GM - Marketing GMP GM - Production GOV Government Mgmt - All Types HLR Labor Relations HRA HR - Overall HRC Compensation/Benefits HRR Recruiting LEG Legal MAD Advertising MAL Marketing - Overall MEI Export/Import MPT Product Management MRS Market Research MSL Sales MSV Mktg. Services - All Types NOP Non Profit Management PAL Manufacturing - Overall PDN Line Pdn Management PLA Strategic Planning PMT Maintenance PPL Production Planning PQC Quality Control PRA Public/Government Relations PSV Pdn Services - All Types RND Research & Development SCH Executive Recruiters TRD Trading

Industry Advertising AGR Agriculture ASS Associations/Trade Groups AUD Auditing BKC Banking Commercial BKI Banking Investment BKP Banking Private BKS Banking S & L CBA Consumer Apparel, Footwear CBB Consumer Beverage CBC Consumer Cosmetics CBE Consumer Electronic CBF Consumer Food CBM Consumer Miscellaneous CBR Consumer Branded CBT Consumer Toys, Bicycles, Sports CHM Chemicals - Raw Materials COE Construction Equipment CON Consulting COS Construction Services EDP Hardware & Software ENG Engineering Firms FLY Aviation All FSC Security & Commodity Brokers FSL Financing, Credit & Leasing GVT Government HIT High Technology HLT Healthcare Equipment HOS Hospital/Nursing Management HOT Hospitality, Hotel, Timeshare, etc. INE Import & Export INS Insurance MAH Manufacturing Heavy MAL Manufacturing Light MCH Machinery MNG Mining NON Non Profit OFC Office Equipment OIL Petroleum - All Types PAP Paper & Packaging PHA Pharmaceutical & OTC PLS Plastic Products PRI Printing & Publishing PWR Power & Energy REC Real Estate Commercial REP Real Estate Private RES Research Institutions RTL Retail RUB Rubber SCE Shopping Center - Mgmt & Lease SCH Executive Search SHP Shipping TNS Transportation - All Types TNT Telecommunications - All Types TRD Trading UTL Public & Private Utilities VEH Vehicles & Parts - All Types WHS Wholesale

Location Country

Start Date  To

Compensation ($US 000's)