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☐ Adaptability/Flexibility ☐ Artistic aptitude ☐ Communication ☐ Confidence ☐ Conflict management ☐ Cooperation ☐ Creativity ☐ Critical Thinking ☐ Customer service ☐ Dealing with difficult people/situations ☐ Decision making ☐ Dependability ☐ Empathy ☐ Enthusiasm ☐ Establishing relationships ☐ Follow rules and regulations ☐ Following directions ☐ Functions well under pressure ☐ Giving clear feedback ☐ Honesty ☐ Independence ☐ Interpersonal skills ☐ Leadership ☐ Listening ☐ Logical thinking ☐ Multitasking ☐ Networking ☐ Organization ☐ Patience ☐ Positive Attitude ☐ Problem solving ☐ Public speaking ☐ Punctuality ☐ Respectfulness ☐ Safety conscious ☐ Scheduling ☐ Self-awareness ☐ Self-directed ☐ Selling skills ☐ Social skills ☐ Staying on task ☐ Storytelling ☐ Stress management ☐ Team player ☐ Technology savvy ☐ Time management ☐ Willing to accept feedback ☐ Willingness to learn ☐ Working well under pressure ☐ Work-life balance ☐ Writing skills Other:

List three people who would be good job references: (1) (2) (3) (H) WORK EXPERIENCE Do you have a resume? Yes ☐ No ☐ Do you need help creating a resume? Yes ☐ No ☐ Provide an updated resume or complete the information below, beginning with your current or most recent job. Employer

Job Title

Duties:

Dates worked from:

to:

Final Hourly Wage

Reason for leaving

Employer

Job Title

Duties:

Dates worked from:

to:

Final Hourly Wage

Reason for leaving

Employer

Job Title

Duties:

Dates worked from:

To:

Final Hourly Wage

Reason for leaving

Employer

Job Title

Duties:

Dates worked from:

To:

Final Hourly Wage

Reason for leaving

What was your favorite job and why?

How often were you absent or late from your last job and why?

What other jobs would you consider?

Have you ever been self-employed or a contractor?

032-22-1090-01-eng

Yes ☐ No ☐ If yes, tell us about it below.

Company’s Name:

What did the company specialize in?

What did you do?

Dates worked from

to

Final hourly pay