Kelley Sample Form - NextGen Executive Retained Search

Full Name
Email
Today's Date
MM slash DD slash YYYY
Leadership and Team Management
Please provide information relevant to the role (maximum last 10 years) in descending order
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built
Add Another row?
- Yes
Employer
Years Managed Team
Total Number of Direct Reports
Team Makeup by Role Titles
Geo Locations
How Team Was Built

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Key Industry & Customer Relationships (Most recent 7 Years)
Depending on the role, this may include external (customers, vendors, partners); if key to success in the role is adding internal customers, please list those also
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Entity - Company Name

If not internal
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Entity - Company Name

If not internal
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Entity - Company Name

If not internal
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Entity - Company Name

If not internal
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Company & Primary Contact
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Company & Primary Contact
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Company & Primary Contact
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Company & Primary Contact
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Company & Primary Contact
Relationship Title
Result of Relationship
Add Another Row?
- Yes
Month
Date Relationship Started
Year
Month
Date of Last Contact
Year
Type Of Contact
Company & Primary Contact
Relationship Title
Result of Relationship

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P&L and Budget Performance (last 10 Years descending by year)
Year
Responsibility
Performance
Increase or Decrease by %
Annual Size (please add the symbols $ or £) & the abbreviations B for billion, M for million, K for thousands – example $43M
Add another row?
- Yes
Year
Responsibility
Performance
Increase or Decrease by %
Annual Size (reminder add the symbols $ or £) and the abbreviations B for billion, M for million, K for thousands – example $43M
Add another row?
- Yes
Year
Responsibility
Performance
Increase or Decrease by %
Annual Size (reminder add the symbols $ or £) and the abbreviations B for billion, M for million, K for thousands – example $43M
Add another row?
- Yes
Year
Responsibility
Performance
Increase or Decrease by %
Annual Size (reminder add the symbols $ or £) and the abbreviations B for billion, M for million, K for thousands – example $43M
Add another row?
- Yes
Year
Responsibility
Performance
Increase or Decrease by %
Annual Size (reminder add the symbols $ or £) and the abbreviations B for billion, M for million, K for thousands – example $43M

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Sales and Revenue Numbers
Please provide information requested to a maximum of the last 10 years in descending order. Items below please add the symbols $ or £ and the abbreviations B for billion, M for million, K for thousands – example $43M
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Year
Responsibility
Annual Target / Quota
Actual Annual Sales
Sales by Customer and Product / Service
Please do not add any customer or sale with less than $400k per sale
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$
Add Another Row?
- Yes
Employer
Date of Sales Close
Major Customer
Primary Decision Maker
Products / Services Sold
Was Sale New or Add-On?
Sales Cycle Pitch to Close
Total Value of Sale $$

Save this form and Continue at a later point in time

Recruiter: Kelley Reinhardt

Client: ABC Corporation

Step 1 of 4

Leadership and Team Management

Key Industry & Customer Relationships (Most recent 7 Years)

P&L and Budget Performance (last 10 Years descending by year)

Sales and Revenue Numbers

Sales by Customer and Product / Service

Charles Moore

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