The Petrillo Agency
PROTECTION WITH A PURPOSE
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about us?
*
(referred by...., online ad, Facebook, LinkedIn, etc.)
How would you rate your interest regarding the position?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
Why?
*
What appeals to you most about a possible career with us?
Based on past accomplishments, what gives you the confidence you would do well with us?
*
Of these, what are the three most important factors in your next career?
*
Culture
Compensation
Stability
Growth Opportunities
Work-Life Balance
When we contact your previous employer, what will they say regarding your work ethic and attitude?
*
Are there any limitations with your schedule regarding your availability to work?
*
Yes
No
If yes, please explain. If no, type N/A.
*
Are there any issues in your past that would appear on a background check?
*
Yes
No
If yes, please explain. If no, type N/A.
*
Back
Next
Do you have a valid driver's license and a reliable vehicle?
*
Yes
No
Please list any additional questions you may have. We can address these during our next meeting.
*
Resume upload
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