Irvine Campus

Chapman University College Career Check-up

Please note that all information on this form is strictly confidential.
(Those items with an "*" must be completed before your form can be processed)

	General Information
*Date
*Name:
*Are you a current Student?
*Are you an Alum?
*Program
*Address
*City	State Zip
*Telephone number
Type of Phone
*E-mail Address
*Have you used the Career Check-up services before?
If so, when?
*How did you hear about the Career Check-up Services?
*What days and times are best for you? M T W TH F/AM PM Evenings
Do you have a preferred consultant (see web page at: www.chapman.edu/irvine) for bios of all of the available consultants.
	Employment Overview
*Most recent occupation/job title:
*Current or most recent employer:
*Years of service in most recent job:
*Current or most recent salary (annualized including bonuses):
	Personal Information
Marital Status:
Children	(if yes, how many )
	Intake Questions
*Identify your initial or primary reason for this session?
*How satisfied are you with your current career/position?
*What is your biggest single career/business success?
*How do you spend your free time?
*How would you spend your productive time if you won a $100 million lottery?
*Where would you like to be in your career in 5 years?
*If you could design an ideal job, what would it look like? (use as much detail as you possible)
*What is your salary goal?
*What are your expectation from your Career Check Up meeting?
What do you read in your spare time?
Is there anything else that you would like us to know about you that would enhance our ability to serve you?
Please post your resume in the following area:

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