Employment Skills Assessment Summary

1

Date* This field is required.

Date

2

Name* This field is required.Please enter your full legal name

First Name

Last Name

3

Email* This field is required.

example@example.com

Confirm Email

4

Phone Number* This field is required.

Please enter a valid phone number.

5

I have a home computer.

YESNO

6

I have a smartphone.

YESNO

7

I have internet access.

YESNO

8

I will be doing all my activities on my phone.

YESNO

9

I don't have a computer or internet and will be coming to WorkSource.

YESNO

10

Do you have an updated resume?

YESNO

11

Do you have a completed master/general application?

YESNO

12

What is your short-term employment goal?

13

What is your long-term career goal?

14

How can we help you achieve your goals?

15

What is your work history? (Part 1)Please provide the company name, your job title and why you left your last 2 jobs

Company Name

Job Title

Start Date

End Date

Reason for leaving

16

What is your work history? (Part 2)Please provide the company name, your job title and why you left your last 2 jobs

Company Name

Job Title

Start Date

End Date

Reason for leaving

17

Is there anything that would prevent you from starting work tomorrow?Answer 'Yes' or 'No'

YESNO

18

Please explain what would prevent you from starting work tomorrow.

19

What skills do you have to offer an employer?

20

What would your past employer say about you?

21

Would you be able to provide a good recommendation from a past employer?

YESNO

22

What is your highest level of education completed?Include any specialized training or certificates

23

What type of work are you looking for?Be as specific as you can