California Indian Manpower Consortium, Inc.

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* 1. Please list the state where you currently live:

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* 2. Why do you think people loose jobs? Check all that apply:

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* 3. If you selected "Other" on question #1 please explain in more detail here:

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* 4. How confident are you in regards to finding, securing or keeping employment? Select below how you feel:

  Not Confident Less Confident Somewhat Confident Confident Very Confident
Confidence in finding, securing or keeping employment:

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* 5. What do you wish you would have known before you started your last job? Please describe below:

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* 6. What motivates you to go to work? Please describe below:

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* 7. Describe the following as they relate to your current or last job:

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