The manager may consider enclosing a "Needs Survey" in the
separation packet that is given to the affected worker at the time
of the layoff. The Needs Survey should be completed by the
affected worker and provided to the staff at WORKFORCE CENTRAL
FLORIDA.
By completing the Needs Survey, the affected worker can focus
on his/her immediate future needs and begin the process of finding
new employment. It will help the worker identify current
skills, knowledge and abilities, and also identify how he/she may
possibly benefit from additional training or certification.
The information contained on the Needs Survey will help
WORKFORCE CENTRAL FLORIDA staff to identify the specific needs of
the worker and provide those services as quickly as possible.
A sample "Needs Survey" is below.
SAMPLE: Needs Survey
Please answer all questions in this questionnaire. The
information you give will help us provide a program to meet your
personal training and career needs and concerns associated with
this layoff. You are not required to provide personal
information, but the completion of this survey would be greatly
appreciated. Individual answers will be CONFIDENTIAL.
Name _____________________________________________
(first, last)
Address _____________________________________________
(street)___________________________________________
(city, county, state, zip)
Phone __________________ Age ______
Male_____ Female _____
Marital Status: Married
_____ Single
______ Single Parent______
Number of Dependents: ______ Under
18 ______ Over 18
Veteran: _____ Yes ______
No
Job Search Assistance
Check all areas of interest/need:
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Resume Writing
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Applications
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Interviewing Techniques
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Cover Letters
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Job Leads/Contacts
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Career Planning
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Employment Agencies
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Career Testing
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Telephone Techniques
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Self Employment
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Video Taping
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Other
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Long Distance Job Leads/Information
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Education and Training
Check all areas of interest/need. Financial assistance may be
available for the following areas:
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GED Testing
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English as a Second Language
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Community Colleges
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On-the-Job Training
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Vocational Schools
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Basic Education Classes
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Computer Skills
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Other
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Area of Career Interest (Please explain in
detail):
Education
Please check the highest level attained:
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8th Grade or Less
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Professional Certificate and Licenses>
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9th - 12th Grade
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High School Diploma
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1 - 2 Years College
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College Degree(s)
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Vocational - Technical School
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Years of Employment with ________ - ________
Years
Future Plans
Check any that may apply. Do you plan to or have you begun
to:
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Search for another job
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Retire
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Enter a retraining program
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Search for work upon or after layoff
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Enroll in school
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Open your own business
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Need assistance with making a decision
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Concerns
Please check all that may apply:
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Lack of skills
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Education
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Limited English skills
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Disability
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Child care availability
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Age discrimination
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Transportation
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Sex discrimination
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Relocation possibilities
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Other (specify)
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Moving and Relocation
Please check all that may apply:
_____Willing to relocate to a different area
Number of miles you are willing to commute to a new job:
___1-10 ___11-20 ___21-30 ___31-40 ___40+
Personal Assistance and Information
If you feel that any of the following issues are of concern,
please check all that may apply:
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Financial management (budget preparation)
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Medical/health insurance
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Credit/debt management
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Unemployment benefits
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Stress management
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Selling a home
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Educational financial aid
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Moving costs of relocation
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Family issues/counseling
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Veterans benefits
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Alcohol/drug use<
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Mortgage/rent payments
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Food stamps/AFDC
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Disability payments
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Legal issues
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Retirement planning
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Social Security benefits
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Other Concerns (please specify):
Salary
What is the minimum salary/wage you would accept in your next
job?
___$7 -
10 ___$11-13 ___$13-15 ___More
than $15
Please express any other concerns or comments that you feel
might assist in the planning of programs and resources for you and
other effected employees.