Employee Information

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* Last name

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* First name

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* Initial

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* Address

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* City

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* State

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* Zip

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* Employee ID Number

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* Location/Campus

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* Position

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* Department

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* Nature of Separation
(Please check all appropriate boxes)

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* How many years of experience do you have in CCISD?

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* If you are taking employment in another neighboring school district, please indicate a corresponding reason below.

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* How would you rate your experience in Clear Creek ISD in the following areas?

  Poor Below Average Average Above Average Excellent
Working relationship with supervisor
Campus support and mentoring
Employee benefits and salary
Professional Development opportunities
District resources
Evaluation procedures
Opportunity for advancement
Administrative support
Overall CCISD experience

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* Additional comments:

If you are moving to a district that uses Eduphoria Workshop, you may request your Professional Learning portfolio be directly uploaded to their system by completing the form at https://docs.google.com/forms/d/1On1bEptJw3e3GlOFqLxGdzUHE4P_5D_ISzPybNEiwTU/viewform

You may also find this form at http://ccisd.net/departments/curriculum-instruction/professional-learning

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