Form Sna-1008a - Employability Assessment
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SNA-1008A FORFF (12-17)
ARIZONA DEPARTMENT OF ECONOMIC SECURITY
Page 1 of 3
Workforce Development Administration
Supplemental Nutrition Assistance Employment and Training (SNA E&T) Program
EMPLOYABILITY ASSESSMENT
BASIC INFORMATION
Name:
Today’s Date:
Home Address:
Mailing Address:
Home Phone No.:
Cell Phone No.:
Message No.:
Email Address:
EMPLOYMENT HISTORY
1. Are you currently employed?
Yes
No
Most Recent Employer
2. What was the name of the last company you worked for?
3. How many hours per week did (do) you normally work?
4. What was your starting hourly wage?
5. What was your ending (or current) hourly wage?
6. What were your dates of employment?
7. How much time off did you have between this job and previous job?
8. What kind of work did you usually do (currently do) for this employer?
9. How many people did (do) you supervise or manage while at this job?
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2
Most Recent Employer
10. What was the name of the last company you worked for?
11. How many hours per week did (do) you normally work?
12. What was your starting hourly wage?
13. What was your ending hourly wage?
14. What were your dates of employment?
15. How much time off did you have between this job and previous job?
16. What kind of work did you usually do for this employer?
17. How many people did you supervise or manage while at this job?
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3
Most Recent Employer
18. What was the name of the last company you worked for?
19. How many hours per week did (do) you normally work?
20. What was your starting hourly wage?
21. What was your ending hourly wage?
22. What were your dates of employment?
23. How much time off did you have between this job and previous job?
24. What kind of work did you usually do for this employer?
25. How many people did you supervise or manage while at this job?
See page 3 for EOE/ADA/LEP/GINA disclosures
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