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          Job Placement Survey
          In order to better serve you, The United Labor Agency is currently collecting job placement information from all those who have recently found employment. Please fill out the information below and click submit. In return, you will be entered in a drawing to win a free $20 Giant Eagle Gift Card.

          Once we have received your submission, we will verify it against our records. Gift Certificate winners will be chosen by early 2010. Winners will be notified by the United Labor Agency shortly thereafter.


          Job Placement Survey
          First Name:
          Last Name:
          Telephone Number:
          E-Mail:
          Last Four Digits of Soc.:
          Job Title:
          Workplace Name:
          Workplace Phone:
          Work Contact Person:
          Brief Description of Job:
          Additional Comments:
          By submitting this form I agree to the following:
          This conest is limited to one entry per person. A submission is only valid once the United Labor Agency has verified that it has met the entry requirements. Only those submissions by individuals who have recently found employment through the United Labor Agency may participate in this contest. This contest is limited one Gift Certificate prize per individual.


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