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I'm Hired!

 The North Central Career Centers Please complete as much of this form as possible and submit it to us.

Your First Name:

Your Last Name:

Your New Title:

Your Home Phone:

Your E-mail:

MOSES ID Number:

 ______________________________________________________________

Company Name:

Company Street Address:

Company City:

Company State:

Zip/Postal Code:

_______________________________________________________________

Date You Began Work:    

Number of hours/week: 

Choose one that applies:

Full-time Part-TimePermanentTemporary

What’s your pay rate?

Choose one: Per Hour Per Week Per Year

What benefits do you get?

_________________________________________________________________

How did you learn about this job? 

You obtained this employment after

What would be the best time to contact you if we need additional information? Choose one:

Morning
Afternoon
Evening

What would be the best way to contact you?

Phone
Mail
Email

Thank you! And Good Luck!

 

Connecting Workers and Employers

 

An Equal Opportunity
Employer / Program
Auxiliary Aids and Services Available Upon Request

 

Leominster Career Center: 100 Erdman Way Leominster, MA 01453 (978) 534-1481 Hearing Impaired:  (978) 534-1657
Gardner Career Center: 25 Main Street Gardner, MA 01440 (978) 632-5050 Hearing Impaired: (508) 792-7571

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