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Student Employment Feedback Form


Date:07/19/08
Name:First: Last:
Email:
Phone:Day: Evening:
Company Name:
Position Title:
Salary: up to 25K  26K - 35K  36K - 45K
 46K - 55K  56K - 75K  Over 75K

Program(s) attended at CSI

Program 1:
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Program 3:

Year: Campus:

If not available for placement, please check one of the choices below and click Submit at the end of this Form.
Not available for placement due to health-related situations
Not available for placement due to continuing education
Not available due to active military service
International students not available due to visa restrictions
Enrolled in Personal Development Courses
Other (please, explain)

Employment Status Options
Placed in the field of study
Placed in a related field
Placed out of field
Not working

How satisfied are you with this job?
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Comments:


How would you rate the work environment? (i.e. supervisor, coworkers, equipment)
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Comments:


What are your responsibilities in this job?


What skill(s) do you use most in this job?


What professional and/or personal skill(s) did you develop through this job?


Would you make any changes to improve the work experience?
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If so, what?




Note: The information reported on this form will be kept confidential.

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