Assessment Clerk Skills Survey
Name: ______________________________________________ Date: _______________________
Position: __________________________________________________________________________
This information becomes part of your application. Your skills, expertise, and education will be rated based on
your answers. Please fill out this form as completely as possible. Under columns three through six, check the
category that best shows the depth of your experience. Do not check more than one column per line.
Years of relevant experience:
Check Degrees (Attach Transcripts):
Full time work
HS/GED
Part time work
Certificate
Area
(*relevant is defined as: customer
service, dealing with the public, dealing
with forms, accounts, records, etc.)
Associate
Major
Bachelor
Major
Model/
Version
Used
Years of
Experience
Training
only (1)
Preformed
with help
(2)
Performed
unaided
(3)
Instructed
others (4)
Office Equipment:
(May be tested)
Keyboarding (wpm _____)
Copy Machine
Fax Machine
Multi-line phones
Other:
Computer Hardware:
PC
Macintosh
Scantron
Other:
Operating Systems:
Windows
Apple
Other:
Word Processing Software:
Microsoft Word
Other:
Continued
2
Assessment Clerk Skills Survey
Model/
Version
Used
Years of
Experience
Training
only (1)
Preformed
with help
(2)
Performed
unaided
(3)
Instructed
others (4)
Spreadsheet Software:
Microsoft Excel
Other:
Database Software:
Microsoft Access
COMPASS
ASSET
Other:
Test Administration:
Written ASSET
Computer COMPASS
Typing
Other:
Test Scoring:
Written
Scantron
Other:
Test Interpretation:
ASSET
COMPASS
Typing
Other:
I have answered the above information to the best of my knowledge.
Signature: ______________________________________________ Date: ________________________
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