Your employment information is very important to us at Albany Technical College.

Please complete this form and return it to Career Services.

For placement assistance contact:
Mrs. Judy Jimmerson at 430-3514, Mrs. Julie Pettway at 430-0516 or Mrs. Sandra Sutton at 430-3939

Name:*

Student ID #:*

Address:*

 

City:*

State:*

Zip Code:*

Phone #:*

Last Term Attended:*

Will Not/Did Not Return Term:


Select ONE in EACH category below


TERMINATION STATUS




REFERRAL STATUS (for Con't Edu)




EMPLOYMENT STATUS












Annual Income


Program:

Campus:

Left with Employable Skills?



Grads/Completer's Employment Information:

Employer:

Job Title:

Address:

City:

State:

Zip Code:

Continued Ed (College):

Program:


Form Completed by: