Placement Information Form

Free Gas

Employment Information Incentive Program
Have You Returned to Work?

Your employment information is important to us and we would like to show our appreciation for your providing this information.

The Career Place will be holding a drawing every quarter for $100 Gas Gift Cards for two individuals.

How can you enter this drawing?  It’s easy!  All you need to do is complete the form below. Or, if you prefer, you may fill out a paper form at our front desk, or call us at 781.932.5500 and press 3.

Good Luck!

For Individuals who have Obtained Employment

The Career Place provides core services free of charge. Our funding is measured in part by successfully matching individuals with training and career opportunities. We request brief information when our customers obtain employment. All information you provide is confidential and is accessed at The Career Place only by those involved in providing services, determining eligibility, or collecting and reporting data. Your individual information is never distributed to any individuals or groups. To report new employment, you may speak with a career counselor, call The Career Place at 781.932.5500, or submit your information online, using the form below.

Congratulations on your new job and thank you for reporting your new employment to us!
*Required fields are marked with an asterisk

Your Information
*Name: *First:  *Last:  MI:
*Address: 
*City:   *State:   *Zip:
Phone:

Employer Information
*Employer Name: 
Address:
*City:   *State:   Zip:

Job Information
*Job Title:
Pay Rate: $   Per:
*Medical Benefits: were offered were NOT offered
*Start Date:
*Expected Duration: more than 150 days less than 150 days
*Full Time: yes no
*Hours/Week:

For Our Records
How did you learn about this position?
Your comments for
The Career Place: