GRADUATION REQUIREMENTS

This form must be completed or
your application for graduation will be void.

Walters State Community College
500 South Davy Crockett Parkway
Morristown, Tennessee 37813-6899

PLACEMENT SERVICES GRADUATE FOLLOW-UP SURVEY

Last Name _______________  First  ___________  Middle Initial  ______
Address _________________________________________________        
City ______________________    State  ______   Zip Code______
Social Security No. ______-_____ -_______
Phone  ______________________   Fax  ______________________
E-Mail Address __________________________________________________
Semester & Year of Graduation __________________________________________________
Major   _____________________   Current Date ________________
 EMPLOYMENT INFORMATION (start with most recent)                                                                   
Name of Employer ______________________________________________
Address ______________________________________________________
City ________________________________ State_____  Zip Code_______
Job Title _________________  Supervisor's Name _____________________
Phone ___________________________________
Dates (From/To Month/Year)___________________________________
Name of Employer ______________________________________________
Address ______________________________________________________
City ________________________________ State_____  Zip Code ______
Job Title __________________  Supervisor's Name ____________________
Phone _______________________________
Dates (From/To Month/Year)_______________________________

1. What are your educational plans after graduation?                                   
        Do not plan to continue education at this time.
 Will enroll at ____________________________________
 Date plan to enter ____________________________________
Major _______________________ Full-time Part-time

2. What are your employment plans after graduation?                                   
Will actively seek employment in my field of training.
Will continue in my present job
Have already accepted employment

Employer ___________________  Immediate Supervisor_______________
Job Title ______________  Date of Employment_______  Phone________
Will enter the military. Branch__________________________________
Induction date _______________________________________________
Will not seek employment after graduation (please check one of the following)
Full-time student status Illness Choice Retired Other

3.What were the primary reasons you attended WSCC?                                     

With plans to transfer to a four-year college
To prepare for a career in my chosen field
To change careers
At the request of my present employer or as a requirement to keep my job
To learn more about a field in which I already worked
For personal growth: I didn't intend to seek employment in the field I studied
Volunteer work.  If so, please give agency name or business.
ADDRESSES

(Please list two addresses other than your own of a relative or someone who will know where you can be reached.)

This section must be completed.
1.Parent's Name ___________________________   Phone No._____________
Address __________________________________________________
City _____________________  State  _____  Zip Code _________
2. Name ___________________________________   Phone No.______________
Address ___________________________________________________________
City _____________________________  State  _____  Zip Code __________
3. Name ___________________________________   Phone No.______________
Address ___________________________________________________________
City _____________________________  State  _____  Zip Code __________

REGISTRATION STATUS WITH PLACEMENT SERVICES

If you wish to us Placement Services to aid in your job search, please select active status. If active registration is selected, you will need a typewritten resume to aid you in your job search. Please submit a resume to Placement Services as soon as possible during the semester you plan to graduate.

Please check one of the following. Your credential file with Placement Services may become active or inactive at anytime. If you wish to become active, simply call our office. If you register as active, you must notify us within three months after graduation or you will automatically be placed inactive.

Active registration-you are currently seeking employment and request that Placement Services send information about job openings.
Inactive registration-you are not currently seeking employment or do not wish to use Placement Services.
If you have chosen active status, please complete the following:
Type of work desired: 1._________________________________
2._________________________________
3._________________________________

List cities/counties in which you would consider employment:

__________________- ____________________-___________________

ALL referrals and references from WSCC Placement Services are in compliance with Affirmative Action/Equal Opportunity Employer. We comply with Title IX of the Education Amendments of 1972, the Rehabilitation Act of 1973 and Americans with Disabilities Act of 1990.