Applicant Assessment Interview Form

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APPLICANT ASSESSMENT INTERVIEW FORM
Date: __________________________
Name __________________________
Birth Date: ___________________
Address ________________________________________________________________
Test Scores:
English: Reading ________________
Writing Sample _______________________
Math: _____________________
Native English Speaker? ____ Yes ____ No
English command comments: _______________________________________________
On Time for Appointment? ______ Appearance:_______________________________
Day Time Availability? _________
Children? ______________ Babysitting Provisions: ____________________________
Babysitting Reliability?____________________________
What is source of support during training? _____________________________________
.
Able to do internship in downtown area? ______________________________________
Reasons for wanting training _______________________________________________
_______________________________________________________________________
Future Plans: ____________________________________________________________
Interviewer's comments: __________________________________________________
_______________________________________________________________________
_______________________________________________________________________
APPLICANT ASSESSMENT INTERVIEW FORM
Date: __________________________
Name __________________________
Birth Date: ___________________
Address ________________________________________________________________
Test Scores:
English: Reading ________________
Writing Sample _______________________
Math: _____________________
Native English Speaker? ____ Yes ____ No
English command comments: _______________________________________________
On Time for Appointment? ______ Appearance:_______________________________
Day Time Availability? _________
Children? ______________ Babysitting Provisions: ____________________________
Babysitting Reliability?____________________________
What is source of support during training? _____________________________________
.
Able to do internship in downtown area? ______________________________________
Reasons for wanting training _______________________________________________
_______________________________________________________________________
Future Plans: ____________________________________________________________
Interviewer's comments: __________________________________________________
_______________________________________________________________________
_______________________________________________________________________
Interpersonal Skills ___________________________________________________
Technology Aptitude _________________________________________________
Access to Computer __________________________________________________
Accept without reservation: ___________________________________________
Accept: ___________________________________________________________
Accept with Reservation: _____________________________________________
Refer to another program: ____________________________________________
HOLOSTIC SCORE: __________HIGH __________MEDIUM _________LOW
Interviewer: ________________________________________________________
.
Street Culture Assessment: Does the candidate exhibit any of the following
characteristics?
Poor Attitude _______________________________________________
Anger _____________________________________________________
“Cool” ____________________________________________________
Defensive __________________________________________________
Entitlement _________________________________________________
Hostile ____________________________________________________
Macho _____________________________________________________
Street Language _____________________________________________

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