Consent Form: Contractors Please complete this form to give AquantUs your consent to release your resume. Section 1: GeneralName(Required) First Middle Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email(Required) Include your email address hereCompany Name and Job Title You're Applying For(Required)Company NameJob Title Add RemoveCopy and paste the Company Name and Job Title of the position you're applying to from the email you received from the recruiter.Consent to Submit Resume(Required) I have not, directly or indirectly, previously submitted my resume to the above referenced company for any position via any other means (including, but not limited to, the internet, another recruiter, or my own network). I give AquantUs, LLC sole consent to release my resume to the above referenced company. I have previously submitted my resume to the above referenced company via a source other than AquantUs. I have previously submitted my resume(Required) MM slash DD slash YYYY Input the most recent date, position and method used to apply to a position with this company.I have previously submitted my resume(Required)Position(s) applied forMethod(s) of submission Add RemoveInput the most recent date, position and method used to apply to a position with this company.Section 2: CompensationMy current (or most recent) "hourly rate" is(Required)Please enter a number from 1 to 999999. Please exclude bonus or other variable compensation from this line. Amount may be verified as part of our client's on-boarding process.My required "hourly rate" for the above position is(Required)Please enter a number from 1 to 999999. Please exclude expected bonus or other variable compensation from this line.My current (or most recent) "base salary" is (for Temp to Perm roles)Please enter a number from 1 to 999999. Please exclude bonus or other variable compensation from this line. Amount may be verified as part of our client's on-boarding process.My required "base salary" is (for Temp to Perm roles)Please enter a number from 1 to 999999. Please exclude expected bonus or other variable compensation from this line.My first available start date is(Required) MM slash DD slash YYYY I'm available to work on this assignment through MM/DD/YY(Required) MM slash DD slash YYYY Please indicate the "end date" or if no end date please indicate your end date as "open".I am legally authorized to work in the United States for any employer(Required) Yes No Visa requirements(Required)Please provide details regarding your work eligibility including type of visa (H1B, TN1, etc.) or work permit, applicable expiration dates, and any other work restrictions.Section 3: ReferencesConsent(Required) I hereby authorize AquantUs to conduct reference checks and make such investigations and inquiries into my employment and educational history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, and other persons from all liability in responding to inquiries connected with this consent and I specifically authorize the release of information by any schools, businesses, individuals, services or other entities listed by me in this form. Furthermore, I authorize AquantUs to release any reference information to clients who request such information for the purpose of evaluating my credentials and qualifications. REFERENCE # 1 - Supervisor(Required) First Last Company Name(Required) Note the Company Name and your Supervisor's Title from when you worked together.Supervisor's Title AND Department(Required) Position Type(Required)Contract positionFull time positionSelect from the drop down whether the role you had was either a full time or contract position.Phone(Required)Email(Required) REFERENCE # 2 - Peer(Required) First Last Company Name(Required) Note the Company Name and your Peer's Title from when you worked together.Peer's Title AND Department(Required) Position Type(Required)Contract positionFull time positionSelect from the drop down whether the role you had was either a full time or contract position.Phone(Required)Email(Required) Reference # 3 - Peer or Supervisor First Last Company Name Note the Company Name and your Supervisor or Peer's Title from when you worked together. Supervisor or Peer's Title AND Department Position TypeContract positionFull time positionSelect from the drop down whether the role you had was either a full time or contract position.PhoneEmail Section 4: VerificationVerification(Required) I understand that any extended offers of employment will be contingent upon successful completion of 1) verification of employment eligibility in the United States, 2) a background check, 3) verification of education, and/or 4) a drug screen. I confirm the degrees and any certifications (i.e. CPA, CIA, etc.) listed on my resume have been issued by the appropriate school and/or issuing authority and are not “in process” or “pending”. I understand that any misrepresentations in this form or on my resume could result in any offer being rescinded. Use the text box below to provide details on any matters that may arise during the verification and background checks outlined above.Provide Details on Any Matter(s) That May Arise During Verification ProcessSection 5: SubmissionEmailThis field is for validation purposes and should be left unchanged.
