verification of work experience

                                                                                                                                        Not Self Employment

                                                                                     DELIVER or mail to:  Michael Turino – Coordinator, Academic Support Services

                                                                                                                 Academic and Career Advisement Center - JCO

                                                                                                                                             103 Jacobetti Center

                                                                                                                                     Northern Michigan University

                                                                                                                    1401 Presque Isle Ave. – Marquette, MI 49855

 

the person named below is requesting work experience verification from your establishment.  please assist the applicant, who is seeking michigan vocational teaching certification, by completing the information below.

 

________________________________________________________   ______________________________         __________  _____  ______________

NAME of Individual Requesting Work Verification                                         Date form is completed                           Social Security Number

 

__________________________________________________________________________________________________________________________

Address of Applicant                                                                           City                                           State                       Zip

 

___________________________________    _____________________________________    ____________________________

 Daytime Telephone Number of Applicant                     Signature of Applicant                          E- Mail Address of Applicant

 

 

1.  The individual named above worked for us from _______________  _______________  to _______________  _______________

                                                                                  month                    year                        month                    year

 

2.  The individual named above worked ________weeks, accumulating a total of _________hours for the entire time period.

 

3.  The job title of the applicant was/is: _____________________________________________________________________

 

4.  Please describe the job duties, tasks, or responsibilities that the applicant performed: (attach additional documents if necessary)

 

_____________________________________________________________________________________________________

 

_____________________________________________________________________________________________________

 

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_____________________________________________________________________________________________________

 

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If the individual named above held more than one job title with your organization, complete an additional “Verification of WorkExperience” form.

 

 

_________________________________________________________________________        _____________   _________________

Name of Work Establishment, Organization, or Company                                                       Area Code       Telephone Number

 

___________________________________________________________________________________________________________

Address of Establishment                                                                         City                          State                      Zip

 

___________________________________________________      ____________________________________________________

Signature of Verifying Official                                                                                   Position of Verifying Official

 

 

 

__________________________________

NMU Use - Date form was submitted

 

 

this form must be notarized – please attach seal and signature.

 

 

 

 

 

 

 

_______________________________________________________________________________

 

 

                              

                                   verification of self-employment work experience

                                               DELIVER or mail to:   Michael Turino – Coordinator, Academic Support Services

                                                                                                          Academic and Career Advisement Center - JCO

                                                                                                                                 103 Jacobetti Center

                                                                                                                         Northern Michigan University

                                                                                                        1401 Presque Isle Ave.Marquette, MI 49855

the person below is submitting self-employment work experience verification from work done for you.  please assist the applicant, who is seeking michigan vocational teaching certification, by completing the information.

 

___________________________________________________    ______________________________________    __________  _____  ______________

NAME of Individual Requesting Work Verification                                       Date form is completed                            Social Security Number

 

___________________________________________________________________________________________________________________________

Address of Applicant                                                                               City                                              State                           Zip

 

__________________________________    ____________________________________________________    ________________________________

Daytime Telephone Number of Applicant                                    Signature of Applicant                                          E- Mail Address of Applicant

 

 

1.  The individual named above, worked on the project below, from ___________  ___________  to __________  _________

                                                                                                                 month               year                    month           year

 

2.  The individual named above worked for a total of _______________ hours to complete the project.

 

3.  Please describe the nature of the work, job duties, tasks, or responsibilities that the applicant performed:

                                                                                             (attach additional documentation as necessary)

 

_____________________________________________________________________________________________________

 

_____________________________________________________________________________________________________

 

_____________________________________________________________________________________________________

 

___________________________________________   _______________________________________  ________________

                  Signature of Customer                                                  Address of Customer                            Phone Number

 

1.  The individual named above, worked on the project below, from _____________  _____________  to ______________ ______________

                                                                                                       month                 year                       month               year

 

2.  The individual named above worked for a total of _______________ hours to complete the project.

 

3.  Please describe the nature of the work, job duties, tasks, or responsibilities that the applicant performed:

                                                                                             (attach additional documentation as necessary)

 

_____________________________________________________________________________________________________

 

_____________________________________________________________________________________________________

 

_____________________________________________________________________________________________________

 

_______________________________________        _______________________________________      _______________

                 Signature of Customer                                                  Address of Customer                                        Phone Number

 

__________________________________________________    ____________________________________________________ 

                   Signature of Self-Employed Applicant                                      Name of Business if Applicable

 

_______________________________

NMU Use - Date form was submitted

 

 

this form must be notarized – please attach seal and signature.

 

 

 

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