1. Name :
2. Date :
3. Company you are interviewing with :
4. Position you are interviewing for :

Company
Responsibilities
Employed from
To
Monthly earnings  $
Company
Responsibilities
Employed from
To
Monthly earnings  $
Company
Responsibilities
Employed from
To
Monthly earnings

Indicate how you think your past employers will describe you

	Serious Weakness	Minor Weakness	Not a Strength or Weakness	Minor Strength	Primary Strength
Ability to solve problems independently
Following instructions from management
Volunteering to do extra work
Getting along with many different kinds of people
Remaining diplomatic when disagreements arise
	Serious Weakness	Minor Weakness	Not a Strength or Weakness	Minor Strength	Primary Strength
Acting decisively to get quick results
Accuracy and completeness in paperwork
Helping keep morale high
Handling a wide variety of duties
Ability to communicate effectively with others
	Serious Weakness	Minor Weakness	Not a Strength or Weakness	Minor Strength	Primary Strength
Taking the lead with other people
Maintaining a high level of organization
Staying positive when things go wrong
Adjusting quickly to changes
Skill in handling people-problems
	Serious Weakness	Minor Weakness	Not a Strength or Weakness	Minor Strength	Primary Strength
Being firm or assertive with others
Handling details with precision
Consistency of mood
Solving a variety of problems
Building close working relationships
	Serious Weakness	Minor Weakness	Not a Strength or Weakness	Minor Strength	Primary Strength
Using persuasive skill to influence others
Punctuality in getting to work and appointments
Putting in extra hours when needed
Versatility in performing different tasks
Working cooperatively with other people

Indicate all of the words or phrases YOU FEEL DESCRIBE YOU

 
           10. What are your primary strengths as an achiever?

 
  11.          How could you be even more effective as an achiever?