Job Log Forms - PDF

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					                   ________________          County Department of Social Services
                                           JOB SEARCH LOG

       Client Name: __________________________ Case Number: ___________
Use this form to keep track of your job search. List every contact you make with an employer.

1. Name of Business: __________________________ Telephone number: _________________
Business Address: ______________________________________________________________
Contact Type:    In-Person    Phone     Online   Contact Date: _________________________
If in-person or by phone, name of contact person and job title: ____________________________
Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ____min.
Results of contact: ___________________________________________________________

2. Name of Business: _________________________ Telephone Number: _________________
Business Address: _______________________________________________________________
Contact Type:    In-Person    Phone     Online    Contact Date: _________________________
If in-person or by phone, name of contact person and job title: _____________________________
Time to complete contact: ____hrs. ____min. Travel time to complete contact: ____hrs. ___min.
Results of contact: ______________________________________________________________

3. Name of Business: _________________________ Telephone number: __________________
Business Address: _______________________________________________________________
Contact Type:    In-Person    Phone     Online    Contact Date: _________________________
If in-person or by phone, name of contact person and job title: _____________________________
Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ____min.
Results of contact: _______________________________________________________________

4. Name of Business: ___________________________Telephone number: _________________
Business Address: _______________________________________________________________
Contact Type:    In-Person    Phone     Online    Contact Date: _________________________
If in-person or by phone, name of contact person and job title: _____________________________
Time to complete contact: ____hrs. ____min. Travel time to complete contact: ____hrs.____ min
Results of contact: _______________________________________________________________


5. Name of Business: ___________________________Telephone number: _________________
Business Address: _______________________________________________________________
Contact Type:    In-Person    Phone     Online    Contact Date: _________________________
If in-person or by phone, name of contact person and job title: _____________________________
Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ____min.
Results of contact: _______________________________________________________________
         DSS-6960 (rev. 10/08)                                                                    1
         Family Support and Child Welfare Services Section
 6. Name of Business: _____________________________ Telephone number: ________________
 Business Address: _______________________________________________________________
 Contact Type:   In-Person    Phone     Online   Contact Date: _________________________
 If in-person or by phone, name of contact person and job title: _____________________________
 Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ___min.
 Results of contact: _______________________________________________________________

 7. Name of Business: _______________________ Telephone number: ______________________
 Business Address: _______________________________________________________________
 Contact Type:   In-Person    Phone     Online   Contact Date: ________________________
 If in-person or by phone, name of contact person and job title: ____________________________
 Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ____min.
 Results of contact: ________________________________________________________________
 8. Name of Business: _______________________ Telephone number: _____________________
 Business Address: _______________________________________________________________
 Contact Type:   In-Person    Phone     Online   Contact Date: ________________________
 If in-person or by phone, name of contact person and job title: ____________________________
 Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ____min.
 Results of contact: ________________________________________________________________

 9. Name of Business: _______________________ Telephone number: _____________________
 Business Address: _______________________________________________________________
 Contact Type:   In-Person    Phone     Online   Contact Date: ________________________
 If in-person or by phone, name of contact person and job title: ____________________________
 Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ____min.
 Results of contact: ________________________________________________________________

 10. Name of Business: _______________________ Telephone number: ____________________
 Business Address: _______________________________________________________________
 Contact Type:   In-Person    Phone     Online   Contact Date: ________________________
 If in-person or by phone, name of contact person and job title: ____________________________
 Time to complete contact: ____hrs. ____ min. Travel time to complete contact: ____hrs. ____min.
 Results of contact: ________________________________________________________________

        I certify that the information given above is true and correct.

Client’s Signature: ___________________________________ Date: _____________

Caseworker’s Signature: __________________________ Date: _____________
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Description: Job Log Forms document sample