Wood County Child Support Work Search Log
Name___________________ Month__________________
IVD# or Social Security#__________________
Note: Employer contacts do NOT require a signature by the employer for verification but you
do need to write down the name of the person you talked to. Your case manager will contact
employers to verify that you have made legitimate contacts. Remember you need to apply for
40 jobs per month and submit this form to the Wood County Child Support Agency at the
end of each month to be in compliance. You can drop of the log in person or by mailing it to the
Wood County Child Support Agency 400 Market St. PO Box 8095, Wisconsin Rapids, WI 54495
Examples
Employer and Person Contacted and CSA
# Date Method of Contact
Position Applied for Contact Information Worker’sVerification
Mobil Gas Station Application Face-to-face Tom Miller. Called Tom 5/10/07
Resume On-line (715)555-5555, application is on file.
1 Cashier Interview
123 North St, Wis. Rapids
McDonald’s Application Face-to-face On-line @
Resume On-line www.mcdonalds.com/jobs
2 Cook Interview
Employer/ Person Contacted/ CSA Worker’s
# Date Method of Contact
Position of Interest Contact Information Verification
Application Face-to-face
Resume On-line
1 Interview
Application Face-to-face
Resume On-line
2 Interview
Application Face-to-face
Resume On-line
3 Interview
Application Face-to-face
Resume On-line
4 Interview
Application Face-to-face
Resume On-line
5 Interview
Application Face-to-face
Resume On-line
6 Interview
Application Face-to-face
Resume On-line
7 Interview
Application Face-to-face
Resume On-line
8 Interview
Application Face-to-face
Resume On-line
9 Interview
Application Face-to-face
Resume On-line
10 Interview
Application Face-to-face
Resume On-line
11 Interview
Application Face-to-face
Resume On-line
12 Interview
Application Face-to-face
Resume On-line
13 Interview
Application Face-to-face
Resume On-line
14 Interview
Application Face-to-face
Resume On-line
Interview
15
Employer/ Person Contacted/ CSA Worker’s
# Date Method of Contact
Position of Interest Contact Information Verification
Application Face-to-face
Resume On-line
16 Interview
Application Face-to-face
Resume On-line
17 Interview
Application Face-to-face
Resume On-line
18 Interview
Application Face-to-face
Resume On-line
19 Interview
Application Face-to-face
Resume On-line
20 Interview
Application Face-to-face
Resume On-line
21 Interview
Application Face-to-face
Resume On-line
22 Interview
Application Face-to-face
Resume On-line
23 Interview
Application Face-to-face
Resume On-line
24 Interview
Application Face-to-face
Resume On-line
25 Interview
Application Face-to-face
Resume On-line
26 Interview
Application Face-to-face
Resume On-line
27 Interview
Application Face-to-face
Resume On-line
28 Interview
Application Face-to-face
Resume On-line
29 Interview
Application Face-to-face
Resume On-line
30 Interview
Application Face-to-face
Resume On-line
31 Interview
Application Face-to-face
Resume On-line
32 Interview
Application Face-to-face
Resume On-line
33 Interview
Application Face-to-face
Resume On-line
34 Interview
Application Face-to-face
Resume On-line
35 Interview
Application Face-to-face
Resume On-line
36 Interview
Application Face-to-face
Resume On-line
37 Interview
Application Face-to-face
Resume On-line
38 Interview
Application Face-to-face
Resume On-line
39 Interview
Application Face-to-face
Resume On-line
40 Interview
Signature ___________________________________ Date_____________