Executive Search Job Order
As the employer, you know exactly what type of professional you are seeking. The more you help us understand your needs, the better we can find the perfect candidate for you. Simply print this form on your printer and send it to us by fax, postal mail or e-mail. Our understanding of your needs will establish the protocol for conducting an effective executive search for you. Ultimately, it is our clear task to formulate a comprehensive plan for sourcing, identifying, contacting, screening and interviewing candidates whom match your requirements. While your criteria will likely be refined and modified as we get to know your needs better, it is helpful to begin with a basic vignette of the type of candidate you prefer. Please complete a form for each position and mail to Pam Pohly Associates - 2707 Woodrow Court, Suite 100, Hays, KS 67601. We look forward to assisting your continued success! Thank you.
Please tell us about you, as the employer:
Your Name______________________ Your Title________________________________________
Name of Your Organization __________________________________________________________
Your Street Address ________________________________________________________________
City ____________________State _____________________ ZipCode _______________________
Office Phone _________________Fax ________________ Your E-mail_______________________
Please tell us about the position you wish to fill; the employee you wish to find:
Exact Position Title _________________________________________________________________
Name of Office / Facility_________________________________City, State____________________
Name of Direct Supervisor ___________________________Supervisor Title___________________
Today’s Date___________ Date you wish to hire by_____________ Preferred Start Date__________
Salary Range: Low Salary $___________ Preferred Salary $____________Top of Range $________
Describe the background and education required for this position:
Educational, Certification & Licensure Preferences (please circle 1 or more below):
HS AA BA OT PT BS BBA BA BSN RN MSN MA MS
LCSW MSW MBA MHA PhD DO MD ACHEOther Educational / Licensure Preference: ______________________________________________
Other Requirement: ________________________________________________________________
What experiences (positions, settings, titles) are absolute minimum requisites for the successful candidate?
________________________________________________________________________________
________________________________________________________________________________
Special skills / knowledge preferred?__________________________________________________
________________________________________________________________________________
How many years of experience do you prefer? (explain)____________________________________
Please describe the personality and team interaction required for the employee:
What personality attributes are you specifically looking for? ________________________________
________________________________________________________________________________
________________________________________________________________________________
What personality attributes would you specifically not like to see in a candidate? ________________
________________________________________________________________________________
Interpersonal skills required__________________________________________________________
_________________________________________________________________________________
Job Objectives and Goals for the successful candidate:
What will be the individual’s first and most important goals? (Please be specific if possible) _______
__________________________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________
Completed by (your name): ________________________________________ Date: ______________
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If mailing, send to:
Pam Pohly Associates
2707 Woodrow, Suite 100
Hays, KS 67601
Office - 785-625-9790