Employment FollowUp Survey

Employment Follow-Up Survey

1. First Name

2. Last Name

3. Email

4. Our records indicate that you exited our program between April 1, 2021 and June 30, 2021. Are you currently employed?*

Yes

5. When did you start your job?

6. Today's Date

7. How long were you employed?

8. What was your weekly wage?

9. What was the name of your employer?

10. What was your occupation?

11. What was your employer's address?

5. Although you are currently unemployed, did you work for pay during the period of April 1, 2021 through June 30, 2021? *