Graduate Attestation/Survey Form
By completing and submitting the form or authorizing the school official to complete it on you behalf, you agree with the information provided. Pleas note that you may be contacted by the Accrediting Commission of Careers Schools and Colleges (ACCSC) or a 3rd Party Accreditor.
GRADUATE'S FULL NAME
CURRENT MAILING/LOCATION ADDRESS
CURRENT PHONE NUMBER
CURRENT EMAIL ADDRESS
Have you worked in your chosen DEC field and received reimbursement since your graduation?
DATE OF INITIAL EMPLOYMENT
EMPLOYER - "Self" if you are working independently and skip down to "FREELANCE CUSTOMER LIST"
What is your current position? (i.e. stylist, truck driver, medical assistant, makeup artist, fabricator, etc.)
EMPLOYER PHONE NUMBER
Please provide your employer's phone number.
EMPLOYER EMAIL ADDRESS
"FREELANCE CUSTOMER LIST"
If you replied to the above question as "Self", please list the last several paid projects with customer contact information. (Name, phone and email address)
I was able to benefit from the skills and knowledge learned in my program by: (check one)
Obtaining a new position that utilizes such skills and knowledge
Obtaining a new position that requires the credential provided through my program
Maintaining a current position that utilizes the skills and knowledge for professional development
Maintaining a current position that utilizes the skills and knowledge for a possible future promotion
Maintaining a current position that utilizes the skills and knowledge for improving job-related skills
My new or current position is a paid job that meets my employment goal through: (check one)
Full-time, permanent work for a single employer (greater than or equal to 20 hours per week)
Part-time permanent work for a single employer (7.5 to less than 20 hours per week)
Self employment with multiple possible customers (e.g. as a small business owner)
Independent contract work with multiple possible customers (e.g. as a freelance contractor)
Temporary agency work (on jobs related to the field of study)
Temporary work (on jobs lasting 1 month or more that could lead to repeated, sustained employment)
Practical training (as allowed by your student visa)
Are you paid for your training related work (please answer 'yes' or 'no')
COMMISSION AND TIPS:
Please check ALL applicable:
Hourly Rate Range:
$8.00 to $12.00
$12.01 to $15.00
$15.01 to $18.00
$18.01 to $21.00
Please check ALL applicable:
Salary rate range:
$20,001 to $25,000
$25,001 to $33,000
$33,001 to $40,000
Please check All Applicable:
If compensated as Self-Employed, please estimate annual compensation:
$20,001 - $25,000
$25,001 - $33,000
$33,001 - $40,000
OR flat rate received per project:
Can DEC's Career Services department offer you any assistance at this time?
By submitting you name below, you are verifing that the above answers are a true and accurate attestation of your employment.
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