WORK SEARCH LOG
Name:
Last 4 Digits of Your Social Security #:
Please provide detailed information for your required
Week of ___________ to ___________ (Sun. – Sat.)
number of weekly work search activities in the space
provided below:
COMPANY #1
Name of Company:
Address:
City:
State:
Zip Code:
Name of Contact Person:
Phone:
Email:
Method of Contact
:
Date of Contact:
(in person, phone, email, fax, etc.)
COMPANY #2
Name of Company:
Address:
City:
State:
Zip Code:
Name of Contact Person:
Phone:
Email:
Method of Contact
:
Date of Contact:
(in person, phone, email, fax, etc.)
COMPANY #3
Name of Company:
Address:
City:
State:
Zip Code:
Name of Contact Person:
Phone:
Email:
Method of Contact
:
Date of Contact:
(in person, phone, email, fax, etc.)
Keep a copy of this form for your records. You can print additional Work Search Logs at