Poplar Bluff Technical Career Center Follow Up Survey

1. Follow-Up Data

50% of survey complete.

Please respond to the prompts below. Your responses will be used only to meet governmental requirements of reporting graduate and non-graduate follow-up data. A fully completed Follow-Up Survey will be entered into a drawing once every two months to win $50 cash. You may complete the survey every two months up to the first 8 months after you leave PBTCC (if your information changes). PBTCC reserves the right to verify the information provided. Thank you for taking the time to fill out this Follow-Up Survey.

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* 1. Please provide your current contact information.

Name:

Address:

City/Town:

State:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

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* 2. What is today's Date?

Date / Time

Date

Time

AM/PM

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* 3. What was your last name at time of graduation/withdrawal/termination?

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* 4. What Years did you attend PBTCC?

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* 5. Are you currently licensed, or attempted to take a licensing test?

Yes

N/A

Other (please specify)

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* 6. If answer is yes, where?

State and License Number

State and LIcense Number

Date attempted test

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* 7. Are you employed?

Yes, Full-Time

Yes, Part-Time

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* 8. If unemployed please state last employment type and current conditions of unemployment.

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* 9. Are you attending College or Trade School to further your education or have attended one since you left TCC?

Yes

Possibly

I have not decided

Other (please specify)

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* 10. If the answer of the previous question is yes please indicate the name of the school.

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* 11. If Employed:

Where? (Name of agency and location)

When were you employed at your present position?

Type of work (present position)

Supervisors Name (present position)

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* 12. Previous Employment:

Agency

Location

Dates (From To)

Supervisors name

Reason for Leaving

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* 13. Are currently enlisted in the miltary in a full time or part time capacity?

Yes

N/A

Other (please specify)

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* 1. Please provide your current contact information.

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* 2. What is today's Date?

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* 3. What was your last name at time of graduation/withdrawal/termination?

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* 4. What Years did you attend PBTCC?

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* 5. Are you currently licensed, or attempted to take a licensing test?

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* 6. If answer is yes, where?

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* 7. Are you employed?

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* 8. If unemployed please state last employment type and current conditions of unemployment.

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* 9. Are you attending College or Trade School to further your education or have attended one since you left TCC?

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* 10. If the answer of the previous question is yes please indicate the name of the school.

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* 11. If Employed:

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* 12. Previous Employment:

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* 13. Are currently enlisted in the miltary in a full time or part time capacity?

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* 14. If the answer is yes to the above question please select the appropriate branch.