21%
Questions marked with a
*
are required
Exit Survey
Contact Information
*
First Name
:
*
Last Name
:
Address 1
:
Address 2
:
City
:
State
:
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Zip
:
*
Phone
:
*
Email Address
:
*
Desired salary:
When can you start?
Month
Day
Year
--
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
--
01
02
03
04
05
06
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23
24
25
26
27
28
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30
31
--
2019
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2021
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2023
2024
2025
Yes
No
*
1. Are you presently employed?
*
2. If so, may we contact your current employer?
*
3. Have you ever been convicted of a felony?
*
4. Have you previously applied for a position or worked for NLUC?
*
5. Are you under 18 years of age?
*
6. Do you require any special accommodations to perform essential job functions?
*
7. Are you legally eligible for employment in the US?
*
8. Do you have any relatives presently employed at NLUC?
Explain any "Yes" answers for questions 3,4,6 or 8 above:
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