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You will receive an Email with confirmation of your meeting date and time with instructions 48 hours prior to meeting.
Thank you! (hit the TAB button to move from answer box to next)
*
1.
What is your first name? (no nicknames - legal name only)
(Required.)
*
2.
What is your last name?
(Required.)
*
3.
Company (laid off from)
(Required.)
*
4.
Most recent job title
(Required.)
5.
Length of employment (years) ex) 10
*
6.
Date of Layoff
(Required.)
7.
Phone number
8.
Email
9.
What is the address where you currently live?
10.
City
11.
Zip
12.
State
13.
How will you attend meeting?
Via the internet or smart phone
via phone
14.
Current Employment status
Not employed yet, still looking.
Not looking for re-employment ex) retiring
Re-Employed... if so, list below
15.
If Re-Employed, please list employer name.
16.
NOTES for PA CareerLink Staff