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Career History -Form Fill

Section One
Q1

Sign Here: Signature

Q2

Full Name*

First Name

Q3

Full Name*

Last Name

Q4

Employer*

Q5

Starting Date Mo/Yr*

Q6

Final Mo/Yr*

Q7

Location*

Q8

Type of business*

Q9

Description of company*

Q10

Your Title*

Q11

What were your managers expectations of you within that role?*

Q12

Responsibilities/Accountabilities given?*

Q13

What did you find there? (List your Major Challenges)*

Q14

Notable Successes/Accomplishments (How did you achieve them?)*

Q15

Failures/Mistakes (Why did they happen, what would you do differently?)*

Q16

Most enjoyable part of your job? Be descriptive.*

Q17

Least enjoyable part of your job? Be Descriptive.*

Q18

Where did your talents shine in this job? Go into detail.*

Q19

Reasons for leaving this job?*

Q20

What was your supervisors Name*

Q21

What was your supervisors Title*

Q22

Where is your supervisor now?*

Q23

Do you give us permission to contact?*

Q24

His/Her Strengths*

Q25

His/Her Shortcomings*

Q26

His/Her thoughts on your Strengths

Q27

His/Her thoughts on your Weaknesses

Q28

His/Her thoughts on your overall performance rating

Q29

Responsibilities/ Accountabilities given?*

Q30

What did youfind there? ( List your Major Challenges )*

Q31

Notable Successes/Accomplishments ( How did you achieve them? )*

Q32

Faliures / Mistakes ( Why did they happen, what would you do differently? )*

Q33

Supervisors Name*

Q34

Supervisors Title*

Q35

Where is your supervisor now*

Q36

Permission to contact?*

Q37

His/Her thoughts on your Strengths*

Q38

His/Her thoughts on your Weaknesses*

Q39

His/Her Overall performance rating of you? 1-10*

Q40

Responsibilities/Accountabilities?*

Q41

Found (Major Challenges)*

Q42

Most enjoyable part of your job? Be Descriptive*

Q43

Least enjoyable part of you job? Be Descriptive*

Q44

Where did your talents shine in this job? Go into detail*

Q45

What was your supervisors title*

Q46

Strenghts

Q47

Weaknesses

Q48

Overall performance rating 1-10*

Q49

What are you looking for in your next job?*

Q50

What are other job possibilities, and how do you feel about each one?*

Q51

Describe your ideal position and what makes it ideal*

Q52

How does this opportunity square with your ideal position? What do you view as opportunities and advantages as well as risks and disadvantages in joining us?*