Name:     ID: 
 
Email: 

STUDENT PLACEMENT SURVEY

Raleigh County Schools MUST conduct a MANDATORY follow-up survey of all students who completed a Career and Technical program either at the high school or at the Academy of Careers and Technology.  Please take a minute to complete the questionnaire below and click on SUBMIT:
 

 1. 

Home phone number:
 

 2. 

Program of study completed at high-school:
 

 3. 

Name of high-school:
 

 4. 

Year completed:
 

 5. 

Program of study completed at ACT:
 

 6. 

List any credentials, certifications, licenses, degrees, etc.
 

 7. 

Please choose from the following to fill in the next box.
ARE YOU:
A. CONTINUING EDUCATION (IN FIELD)            IF SO, WHERE?
B. CONTINUING EDUCATION (OUT-OF-FIELD)      IF SO, WHERE?
C. MILITARY. IF SO, WHICH BRANCH?
D. EMPLOYED IN FIELD.
E. EMPLOYED OUT-OF-FIELD
F. SEEKING WORK
G. UNAVAILABLE FOR WORK
 

 8. 

Name of employer or business:
 

 9. 

Mailing address of employer or business:
 

 10. 

Supervisors name:
 

 11. 

Phone number of employer or business:
 

 12. 

Wage/salary (Optional)
 

 13. 

Type of work/duties:
 



 
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