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Active
Externship
Graduate
Exam/License
Employment
Notes
Verification

Notes

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Employer Options

Add Employer

Student Options

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Select a Student Option

Student Profile

First Name: Last Name:

SSN: Student ID:

Cell Phone: Home Phone: Secondary Phone

Email Social Media

Referred By: Referral:

Addresses

Primary:

Address 1: Address 2:

City: State: Zip:

Primary	Address	Address 2	City	State	Zip
Yes	1151 W. Testing Dr.	Apt. B	Corona	CA	92882
No	62442 E. Hope Dr.	Unit A	Riverside	CA	92506

Active

Program: Campus: Student Status:

Start Date: Expected Grad Date: Hours Completed: Grad Date:

Student Status

Pre-Application Eligibility: Ineligibility Reason: Pre-Application Processed By: Pre-Application Date:

Check Requested: Date:

Check Received: Date:

Application/ Check Sent: Date:

Check Returned to Corporate: Date: Reason:

	Check Requested Date		Check Received Date		Check Sent Date		Check Returned Date	Check Returned Reason
Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	Transferred
Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	No

Externship Eligibility

Externship Eligibility: Reason:

Referred By: Referral:

Externship Partner Search

Current Externship Information

Employer Name: Contact:

Phone: Email:

Address: Address 2:

City: State: Zip:

Start Date: Position:

Student Summary

Graduate Pre-Applied for State Exam on:

Graduate Participated in Externship:

Externship Partner Name: Externship Partner Address:

Written Date: Written Result:

Practical Date: Practical Result:

License Number:

Plaque Distributed:

Graduation Date:

Proof of Training:

Graduate Eligible for Employment:

Hire Date: End Date:

Title: Salary:

Employer Name: Employer Address:

Graduate Application

Application Processed By: Application Date:

Check Requested: Date:

Check Received: Date:

Application/ Check Sent: Date:

Check Returned to Corporate: Date: Reason:

	Check Requested Date		Check Received Date		Check Sent Date		Check Returned Date	Check Returned Reason
Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	TBD
Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	No

License

License #: License Date: Verfied By:

Plaque Distributed: Date:

Proof of Training

Exam History

Written Test Date: Result: Practical Test Date: Result:

Re-Application

Re-Application Processed By: Re-Application Date:

Check Requested: Date:

Check Received: Date:

Application/ Check Sent: Date:

Check Returned to Corporate: Date: Reason:

	Check Requested Date		Check Received Date		Check Sent Date		Check Returned Date	Check Returned Reason
Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	TBD
Yes	01-01-1000	Yes	01-01-1000	Yes	01-01-1000	No

Temporary License

Graduate Employment

Step 3: Complete Employment Record

Employment Eligibility: Waiver Reason: Documents Secured:

Employer Information:

Employer Name: Employer Contact: Contact Postition:

Phone: Email:

Address 1: Address 2:

City: State: Zip:

Job Information:

Job #: Position Type:

Hire Date: End Date: Title:

Salary: Salary Type: Hours Per Week:

Other Revenue: Commission %: Tips %:

					Hire Date	End Date	Title	Employer	Address	Address 2	City	State	Zip	Phone	Contact Name	Contact Position
					01-02-2013	02-01-2013	Stylist	Fantastic Sams	1151 W. Mockingbird Dr.	Apt. B	Corona	CA	92882	951-999-9999	Sarah G.	Manager
					01-15-2012	01-03-2012	Colorist	Super Cuts	62442 E. Hope Dr.	Unit A	Riverside	CA	92506	951-999-9999	Linda Adams	Supervisor

Step 1: Select Employment Type

Graduate Employment: Required Documentation: Hired from Externship: Address Type:

Step 2: Find Employer

Notes

Created By	Created Date	Category	Note
Diane Franks	01-03-2013	Employment	Student employer Contact Info will need to be updated. New Manager will be new Contact, as of 03-01-2013
Allyssa Jones	02-05-2013	Active	Validate that Pre-application check has been received

Complete Note:

Created By: Created Date:

Category

Note:

Employment Verification:

Employment Type: Verification Status:

Hire Date: End Date: Employer Name:

Contact Name: Contact Position:

Phone: Email:

Hired from Externship: Position: Salary:

Employment Type	Verification Status	Hire Date	End Date	Employer	Contact Name	Contact Position	Phone	Email
Self-Employed	Valid	01-02-2013	02-01-2013	Fantastic Sams	Sarah Gibbons	Manager	951-999-9999	s_gibbons@fantasticsams.com
Employed By Others	Invalid	05-02-2013	06-01-2013	Super Cuts	Jennifer Styles	Manager	951-999-9999	jenStyles@supercuts.com

Employed By Others Verification:

Contact Status: Contact Date:

Contact
First Name: Contact
Last Name:

Verification Status: Documentation:

Verified by
First Name: Verified by
Last Name: Verified Date:

Contact Status	Contact Date	Contact First Name	Contact Last Name	Verification Status	Documentation	Verified By First Name	Verfied By Last Name	Verified Date
Successful	04-01-2013	Sarah	Gibbons	Valid	Employer Survey	Jean	Simple	03-02-2013
Attempted	03-02-2013	Sarah	Gibbons	Pending

Self-Employment Verification:

Verification Status: Documentation: Notarized Self-Certification:

Address Type:

Verfied by
First Name: Verfied by
Last Name: Verfied Date:

Graduate Verification:

Employment Eligibility: Waiver Reason: Documents:

Verification Status: Verified Date:

Verified by
First Name: Verified by
Last Name: