Name:
Title:
Organization:
Year Established:
Address:
City:
State:
Zip:
Telephone:
Fax:
Email Address:
Web Site:
Length of time with current firm:
yrs
Length of
time in executive search:
yrs
Specializations:
Industries:
Number of Consultants:
In house Researchers:
Administrative:
Retained Executive Search:
% Contingency Executive
Search:
%
Minimum Salary Level of Executive Searches: $
Average Salary Level of Executive Searches: $
I hereby request membership in The Executive Recruiter’s
Roundtable and promise to abide by its By-Laws, a copy
of which I have received.
