Career Services - Graduate Placement Survey

First name: MI: Last name:
*Street address:
City: State: *Zip Code:
Telephone:
E-mail address:
Clark State Student ID #: Student ID Help
*Clark State major:
*Required fields

Are you currently employed? Yes No
If yes, full-time part-time

Please provide the following information about your present job:
Name of employer:
Street address:
City: State: Zip Code:
Telephone:
Your job title:

Were you working at this position before enrolling at Clark State? Yes No
Were you working at this position before graduating from Clark State? Yes No
How does this position relate to your course of study at Clark State?
Do you feel that your degree prepared you to perform successfully in your current position? Yes No
Please comment:
What is your current salary? Salary is per
(Salary information will be kept confidential and is for averaging purposes only.)

Please help the faculty. In order to improve academic programs, Clark State surveys employers to learn their opinions about graduate success in the workplace. Please help by allowing us to contact your immediate supervisor. *This information will be kept confidential and is for statistical purposes only.*

May we contact your employer? Yes No
By answering "Yes" to this question you are agreeing that we may contact your present employer.
Supervisor's name:
Supervisor's job title: