Snap Job Search Report
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3SNAP Job Search Report
Name ______________________________________ Case Number _______________________
th
th
Please submit your completed job search forms to: __________________ by: the 15
and 30
of each month.
In order to get credit for your job searches, please make sure that you fill out all of the information requested and sign this form.
Participant’s Statement: I personally filed applications with the employers below and the information contained in this job search is complete and correct.
Signature: ________________________________________
Date: ______/______/______
Employer Name-1
Employer Name-2
Employer Address/Website
Employer Address/Website
Date Visited
Job Title:
Date Visited
Job Title
Employer’s Phone number/Email
Employer’s Phone number/Email
Person Contacted
Person Contacted
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Application Filed
Hired for Job: Start date ________
Application Filed
Hired for Job: Start date ________
Interviewed
Other: _______________________
Interviewed
Other: _______________________
Employer Name-3
Employer Name-4
Employer Address/Website
Employer Address/Website
Date Visited
Job Title:
Date Visited
Job Title:
Employer’s Phone number/Email
Employer’s Phone number/Email
Person Contacted
Person Contacted
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Application Filed
Hired for Job: Start date ________
Application Filed
Hired for Job: Start date ________
Interviewed
Other: _______________________
Interviewed
Other: _______________________
Employer Name-5
Employer Name-6
Employer Address/Website
Employer Address/Website
Date Visited
Job Title:
Date Visited
Job Title:
Employer’s Phone number/Email
Employer’s Phone number/Email
Person Contacted
Person Contacted
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Application Filed
Hired for Job: Start date ________
Application Filed
Hired for Job: Start date ________
Interviewed
Other: _______________________
Interviewed
Other: _______________________
Employer Name-7
Employer Name-8
Employer Address/Website
Employer Address/Website
Date Visited
Job Title:
Date Visited
Job Title:
Employer’s Phone number/Email
Employer’s Phone number/Email
Person Contacted
Person Contacted
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Application Filed
Hired for Job: Start date ________
Application Filed
Hired for Job: Start date ________
Interviewed
Other: _______________________
Interviewed
Other: _______________________
Employer Name-9
Employer Name-10
Employer Address/Website
Employer Address/Website
Date Visited
Job Title:
Date Visited
Job Title
Employer’s Phone number/Email
Employer’s Phone number/Email
Person Contacted
Person Contacted
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Application Filed
Hired for Job: Start date ________
Application Filed
Hired for Job: Start date ________
Interviewed
Other: _______________________
Interviewed
Other: _______________________
SNP15-103
Rev. 12/22/15
Page 1 of 2
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