| Identification |
| 4. Mailing Address |
| | mailing address |
| 5. Postal Code |
| | 55337 |
| 6. Home Phone (international format) |
| | 952.435.xxxx |
| 7. Work Phone (international format) |
| | 612.904.xxxx |
| 8. Your preferred e-mail |
| | prefferred |
| 9. Boss e-mail |
| | boss |
| 10. Father's last name (first five characters) |
| | beuke |
| 11. City of birth (first five characters) |
| | tyler |
| 14. Are you working as a expatriate right now? |
| | No |
| Education - Amount & High School/Secondary School Information |
| 15. Indicate your highest level of education: |
| | Undergraduate degree (B.A., B.S., B.Sc., Maitrise) |
| 16. High/Secondary school name & Location |
| | high school |
| 17. Attended High/Secondary school FROM date |
| | beginning |
| 18. Attended High/Secondary school TO date |
| | end |
| 19. Did you graduate from high/secondary school? |
| | Yes |
| 20. Grade Average (4 pt. scale) |
| | average |
| Education - College 1 |
| 21. College 1 name & Location |
| | college 1 |
| 22. Attended College 1 FROM date |
| | 11/22/33 |
| 23. Attended College 1 TO date |
| | 22/33/44 |
| 24. Did you graduate from college 1? |
| | Yes |
| 25. College 1 Grade Average (4 pt. scale) |
| | avg |
| 26. College 1 Degree |
| | bs |
| 27. College 1 Major & Minor |
| | eng |
| Education - College 2 (if applicable) |
| Education - College 3 (if applicable) |
| Education - College 4 (if applicable) |
| Education - General information |
| 49. In what subjects did you do best? |
| | stuff I liked |
| 50. In what subjects did you do least well? |
| | stuff I disliked |
| 51. What work did you do during your school years and when (indicate whether part- or full-time)? |
| | worked at home |
| 52. What portion of your education costs did you earn yourself? |
| | most |
| Professional Development |
| 54. Describe any professional, civic, or vocational leadership roles or invo
lvement of yours that have contributed to your professional growth: |
| | prof dev |
| Employment |
| 59. Why did you go into your current line of work? |
| | "It seemed to be the logical thing to do at the time." - Sarak |
| 62. What is the approximate number of people in the company that employs you, including all divisions? |
| | 350 |
| 67. Which one of the following best represents your current management role? |
| | Supervisor of hourly or clerical people |
| Work History - Five years ago to the present |
| 69. Organization 1 |
| | org 1 |
| 75. Organization 2 |
| | org 2 |
| 81. Organization 3 |
| | Org 3 |
| 87. Organization 4 |
| | Org 4 |
| 114. During this time period, what did you like best about your work? |
| | good things |
| 115. During this time period, what did you like least about your work? |
| | Bad things |
| Work History - Five to ten years ago |
| 158. During this time period, what do you consider to be your greatest accomplishment? |
| | Too long ago to remember |
| Work History - Ten or more years ago (to the start of your career) |
| 163. Organization 1 |
| | Memory going |
| 178. Responsibilities in Organization 3 |
| | dfasadfgasdfasdf |
| 193. Organization 6 |
| | asdfasdfasdfasdfasdfewrqwerqwer |
| Work Environment |
| 210. If you could combine any job elements into an ideal job, what would it be? (Describe) |
| | High pay, low responsibility |
| 211. Think of aspects of work environment that make it difficult for you to do your job. (Describe) |
| | Users |
| 212. You have 100 preference points to distribute on the factors listed below. Distribute the points in a way that accurately orders their priority or importance to you. You may give zero points t
o those job factors for which you have little or no desire. Stimulating, challenging work content |
| | 1 |
| 213. Achievement and a sense of accomplishment |
| | 2 |
| 214. Variety |
| | 3 |
| 215. Compensation (salary plus incentives, bonus, etc.) |
| | 4 |
| 216. Independence to set own direction |
| | 5 |
| 217. Creativity |
| | 6 |
| 218. Responsibility for resources and decisions |
| | 7 |
| 219. Fair and consistent supervisors |
| | 8 |
| 220. Structure and practices that ensure stability |
| | 9 |
| 221. Friendly relations with coworkers, vendors and/or clients |
| | 10 |
| 222. Service to the community, people, or a cause |
| | 11 |
| 223. Advancement (promotions) |
| | 12 |
| 224. Being perceived as an expert or authority |
| | 13 |
| 225. Visibility and recognition |
| | 14 |
| 226. Power and influence |
| | 15 |
| Career Aspirations |
| 227. How interested currently are you in making a career move and why? |
| | Not. No jobs |
| Self-Evaluation |
| 239. Over the years, what strengths have peers, supervisors, and if applicable, subordinates consistently observed in you? |
| | Not many |
| 240. What would they identify as your areas of greatest relative weakness or development need? |
| | Everything else |
| Comments |
| 248. If you feel we should have any additional information in order to better understand you and your career, please add it here. |
| | This is a comment |