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. An example has been provided in the first box.
Example:
Employer Name:
CareerSource Pinellas
Employer Address/Email Address:
th
13805 58
Street N., Clearwater, FL 33760
Date Visited:
Job Title:
01-14-14
Front Desk Clerk
Employer’s Phone number:
Person Contacted:
Lisa – Office Manager
727-524-4344
Result of Visit (MUST CHECK ONE/COMPLETE OTHER FIELD)
Application Filed
Hired for Job: Start date ________
Interviewed
Other: _______________________