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Country of origin: US
File type: PDF

BROWSE OTHERS (US) FORMS

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Campus Name
GRADUATE EMPLOYMENT STATUS/Graduate
Graduate Name: _________________________________________
Thank
you for taking the time to complete this Employment Status Form. We will use the information you provide below to calculate
the job placement rates we publish to students and the public in advertisements and recruiting materials. The Graduate
Employment Rates and Salaries are shown in an average and no individual information will be published. By completing and signing
this form or authorizing the school official to complete it on your behalf, you agree with the information provided. By submitting this
form you understand and agree that the information in this form may be provided to, and you may be contacted by the school’s
designated representative including but not limited to Compliance Point, and/or the school’s accreditation or regulatory agency in
order to verify the information provided.
Graduate’s Supervisor Name/Title: ___________________________________________________________________________
Supervisor e-mail: __________________________________________________ Phone Number:_________________________
Employer/Company Name: __________________________________________________________________________________
Employer/Company/ Address:________________________________________________________________________________
Graduate’s Position/Title: _________________________________ Start Date: ______________ End Date: _________________
(if applicable)
Ple
ase attach a Job Description if available, if not please provide job description:
______
_____________________________________________________________________________________________________
___________________________________________________________________________________________________________
Do you manage other employees? □ Y
es □ No
Do you use skills you learned in your program in your position?
□ YES
(If YES, please explain below): □ NO
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Does the position have a planned end date? □ Yes □ No If Yes, what is the planned end date? ______________
_______
Pl
ease complete the question below as it applies to you:
□ I agree that the education I received provided a benefit or advantage in obtaining this position in the following way:
________________________________________________________________________________________________
_________________________________________________________________________________________________.
If y
ou are continuing in the same position you had before you enrolled for your program, please check all that apply:
□ Completing the program enabled me to maintain my position.
□ I have earned a promotion as a result of completing the program.
□ I have earned an increase in pay as a result of completing the program.
□ None of the above apply to me.
Has
your employer paid for 50% or more of the cost of tuition for you to attend this Program of Study?
□ Yes □ No
Number of Hours Scheduled Hours Per Week:______ If Hours Vary, please provide range of hours worked per week: ___ to ___
Is this position paid? Yes No
(rev 4/21/2016)
Campus Name
GRADUATE ACKNOWLEDGEMENT
I acknow
ledge that the information provided above is true and correct.
TYPE OR SIGN NAME: (Graduate Only)
Grad
uate Name: Date: Email address: _______________________
FOR SCHOOL USE ONLY
Graduate ID: ____________________ Graduation Date: ________________ Program/Degree: _____________________________________
Form completed by: □ Graduate □ Career Service Staff Member – check one of the following: □ Verbal □ Written Verification attached
□ Graduate provided written job description
My signature below verifies that I have obtained the required supporting documentation for this graduate’s status and that the information above
is true and correct. (Sign, affix Image Now stamp or attach email approval)
Career Services Representative: _______________________________ Print Name: ________________________Date Verified:_________
(Signature)
Career Services Leadership: ________________________________Print Name: ______________________Date Verified: _________
(S
ignature)
Two Week Verification Completed
□ Written from Graduate □ via this form □ attached □ Written by Employer □ on file
□ Verbally with Graduate on _______________________ (date & time) □ via phone □ in person
□ Verbally by Employer □ on file
Verified the following information is still the same: □ salary □ hours □ job title □ duties □ specified end date
Thirty Day Verification Completed:
□ Written from Graduate □ via this form □ attached □ Written by Employer □ on file
□ Verbally with Graduate on _______________________ (date & time) □ via phone □ in person
□ Verbally by Employer □ on file
Verified the following information is still the same: □ salary □ hours □ job title □ duties □ specified end date
Comments, verbal or written re-verification documentation: (Please add your name and date to notes below and document in graduate record in
SIS.)
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Completed 15 July 2021

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