Employer:______________________________________Supervisor’s Name: ______________________________
Address: ______________________________________________________________________________________
Telephone: ____________________________________________________________________________________
Your Job Position: ___________________________________________ From: ______________ To: ____________
What did you like most about your job? ____________________________________________________________
What did you like least about your job? _____________________________________________________________
Were you discharged from this job?
Yes
No
If No, what was your reason for leaving: _____________________________________________________________
Employer:______________________________________Supervisor’s Name: ______________________________
Address: ______________________________________________________________________________________
Telephone: ____________________________________________________________________________________
Your Job Position: ___________________________________________ From: ______________ To: ____________
What did you like most about your job? ____________________________________________________________
What did you like least about your job? _____________________________________________________________
Were you discharged from this job?
Yes
No
If No, what was your reason for leaving: _____________________________________________________________