Let’s Get Started! Excited to move forward? Fill out the intake form below, and we’ll be in touch after reviewing your info! Client Information Company Name First Name Last Name Address: Contact Name & Title Email Phone (###) ### #### Does your organization have internal HR or recruiting support? Yes No If yes, please describe their role in the hiring process: Hiring Details Number of Positions to Fill: 1-4 5-10 Job title(s): Department/Division: Work Location Hourly Rate or Salary Range: Employment Type: Full-Time Part-Time Contract Position Details Job Summary/Key Responsibilities: Required Skills or Qualifications: Nice-to-Have Skills Preferred Interview Platform: In Person Zoom Phone Other Target Questions for Consultant Pre-Screen: Please Check if applied Is a valid drivers license required? Is a background check required? Is drug screen required? Is a physical exam required? Other pre-employment requirements? Preferred Start Date Hiring Manager (if different from contact) Interview Availability Client agrees to provide interview time slots within 3 business days of receiving qualified candidate submissions. Preferred Days/Times Authoriztion By signing below, Client acknowledges the information provided is accurate and agrees to begin recruitment services under the terms of the Rooted Acquisitions LLC Recruiting Consultant Agreement. Name First Name Last Name Date MM DD YYYY Thank you so much! We’ll be in touch soon to chat about next steps — we’re really excited about the chance to work together!