Occupational Course of Study Career Portfolio Checklist

Student Name:
Doc. 1 Doc. 2 Doc. 3 Doc. 4 Doc. 5 Doc. 6 Doc. 7 Doc. 8 Doc. 9 Doc. 10 Doc. 11 Doc. 12 Doc. 13 Doc. 14 Doc. 15 Doc. 16 Doc. 17 Doc. 18 Doc. 19 Doc. 20 Doc. 21 Doc. 22 Doc. 23 Doc. 24 Doc. 25 Cover Sheet Personal Information Medical Information Financial Information Educational Information High School Record Summary of Career Technical Education Courses High School Transcript High School Record Extracurricular Participation and/or Career Goals Vocational Assessments Career Exploration Career Preparation Record School Based (On Campus) Training Work Evaluation Summaries School Based (On Campus) Training Career Preparation Record Community Based Vocational Training Work Evaluation Summaries Community Based Vocational Training Completed Job Application Career Preparation Record Competitive (Paid) Employment Work Evaluation Summaries Competitive (Paid) Employment Employment Information Reference Information Letters of Recommendation Completed Resume Verification of Work Hours Examples of Work Site Pictures Examples of Work Site Pictures Examples of Work Site Pictures Examples of Work Site Pictures

PERSONAL INFORMATION
(Type or print all information)

Name
Last First Middle

Present Address

Street or P.O. Box

Apt. #

City

State

Zip

Telephone
Home Work

Previous Address

Street or P.O. Box

Apt. #

City

State

Zip

Date & Place of Birth Personal Numbers

Date of Birth

Place of Birth (City and State)

Social Security Number

Drivers License Number

Do not complete
Health Insurance Company and Policy Number

Do not complete
Auto Insurance Company and Policy Number

Other Information

MEDICAL INFORMATION
Confidential
In Case of Emergency Notify:
First Name Middle Initial Complete Street Address City Telephone Number State Zip Relationship Middle Initial Address City Telephone Number State Zip Type of Doctor Last Name Last Name

Doctors Name

First Name

Other Health Related Information

Name of Preferred Hospital Complete Street Address City Telephone Number Name of Insurance provider Known Allergies: Serious Medical Condition(s): NA Rx meds taken: NA Dosage: NA Times: NA Over the Counter Medication: NA State Zip Blood Type Policy number

Rx meds taken: NA Dosage: NA Times: NA

FINANCIAL INFORMATION
OMIT
Bank Information

Confidential Information
Complete Name of Bank/Branch Complete Street Address City Checking Account Other Accounts/Loans State Saving Account

OMIT

Zip Auto Loan

Credit Card Information

Name of Credit Card Address City State Zip Name of Credit Card Address City State Zip

Account Number Balance Monthly Payments Zip Account Number Balance Monthly Payments Hourly Rate Monthly Net Salary Monthly Utility Payments Monthly Car Payment

Other Financial Information

Annual Income

Monthly Rent/Mortgage Payment Monthly Insurance Payments Other Financial Information :

OMIT THIS FORM FOR SECURITY REASONS

EDUCATIONAL INFORMATION
(Type or print all information)

High School Attended

Complete Name of High School

Complete Street Address

City

State

Zip

Yes
Years Attended Year of Graduation Diploma

No

Specialized Training, Education Program or Post Secondary School(s) Attended

Complete Name of School/Agency

Complete Street Address

City

State

Zip

Duration of Experience

Outcome/Degree/Certification

Graduation/Completion Date

Complete Name of School/Agency

Complete Street Address

City

State

Zip

Duration of Experience

Outcome/Degree/Certification

Graduation/Completion Date

Complete Name of School/Agency

Complete Street Address

City

State

Zip

Duration of Experience

Outcome/Degree/Certification

Graduation/Completion Date

Special Interests or Skills

High School Record

Summary of Career & Technical Education Courses Taken
Credit # 1 Course Title: Course Description:

Credit # 2 Course Title: Course Description:

Credit # 3 Course Title: Course Description:

Credit # 4 Course Title: Course Description:

High School Record

Summary of Career & Technical Education Courses Taken
Credit # 5 Course Title: Course Description:

Credit # 6 Course Title: Course Description:

Credit # 7 Course Title: Course Description:

Credit # 8 Course Title: Course Description:

Document 6 High School Transcript

High School Record

Extracurricular Participation and/or Personal and Career Goals
Year: Activity. Community Participation, Honors, Year: Activity. Community Participation, Honors,

Year: Activity. Community Participation, Honors,

Year: Activity. Community Participation, Honors,

VOCATIONAL ASSESSMENTS
Date: Name of Interest Inventory: Areas of High Interest:

Areas of Low Interest:

Jobs Related to High Interest Areas:

Date: Name of Interest Inventory: Areas of High Interest:

Areas of Low Interest:

Jobs Related to High Interest Areas:

Interest Career Matches:

VOCATIONAL ASSESSMENTS
Date: Name of Interest Inventory: Areas of High Interest:

Areas of Low Interest:

Jobs Related to High Interest Areas:

Date: Name of Interest Inventory: Areas of High Interest:

Areas of Low Interest:

Jobs Related to High Interest Areas:

Interest Career Matches:

CAREER EXPLORATION
Date: Career: Work Requirement Summary: Salary Range:

Educational/Training Requirements:

Local Employer(s) & Location:

Date: Career: Work Requirement Summary:

Salary Range:

Education/Training Requirements:

Local Employer(s) & Location:

CAREER EXPLORATION
Date: Career: Work Requirement Summary: Salary Range:

Educational/Training Requirements:

Local Employer(s) & Location:

Date: Career: Work Requirement Summary:

Salary Range:

Education/Training Requirements:

Local Employer(s) & Location:

Career Preparation Record

School Based (On Campus) Training Experience
Date of Experience: Number of Hours Worked: Location: Job Duties: Job/Career Field: Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field: Name of Supervisor:

Career Preparation Record

School Based (On Campus) Training Experience
Date of Experience: Number of Hours Worked: Location: Job Duties: Job/Career Field: Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field: Name of Supervisor:

Work Evaluation Summaries

School Based (On Campus) Training Experiences
(Include samples of actual evaluation forms and time cards as documentation for community based work training experiences.)

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Work Evaluation Summaries

School Based (On Campus) Training Experiences
(Include samples of actual evaluation forms and time cards as documentation for community based work training experiences.)

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation School Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Career Preparation Record

Community Based Vocational Training Experience
Date of Experience: Number of Hours Worked: Location: Job Duties: Job/Career Field: Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field: Name of Supervisor:

Career Preparation Record

Community Based Vocational Training Experience
Date of Experience: Number of Hours Worked: Location: Job Duties: Job/Career Field: Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field Name of Supervisor:

Date of Experience: Number of Hours Worked: Location: Job Duties:

Job/Career Field: Name of Supervisor:

Work Evaluation Summaries

Community Based Vocational Training Experiences
(Include samples of actual evaluation forms and time cards as documentation for community based work training experiences.)

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Work Evaluation Summaries

Community Based Vocational Training Experiences
(Include samples of actual evaluation forms and time cards as documentation for community based work training experiences.)

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Community Based Training for school year

Average scores in each area Total Hours Completed:

Quality of Work

Attitude/Cooperation

, semester Teamwork

Productivity

Nature of Work Performed:

Document 14 Completed Job Application

Career Preparation Record

Competitive (Paid) Employment Experience
Business: Address: City/St/Zip: Phone: Supervisor: Job Responsibilities: Career Field: Start Date: End Date: Total Employment Time: Hourly Rate:

Business: Address: City/St/Zip: Phone: Supervisor: Job Responsibilities:

Career Field Start Date: End Date: Total Employment Time: Hourly Rate:

Business: Address: City/St/Zip: Phone: Supervisor: Job Duties:

Career Field Start Date: End Date: Total Employment Time: Hourly Rate:

Career Preparation Record

Competitive (Paid) Employment Experience
Business: Address: City/St/Zip: Phone: Supervisor: Job Responsibilities: Career Field: Start Date: End Date: Total Employment Time: Hourly Rate:

Business: Address: City/St/Zip: Phone: Supervisor: Job Responsibilities:

Career Field Start Date: End Date: Total Employment Time: Hourly Rate:

Business: Address: City/St/Zip: Phone: Supervisor: Job Duties:

Career Field Start Date: End Date: Total Employment Time: Hourly Rate:

Work Evaluation Summaries

Competitive (Paid) Employment
(Include samples of actual evaluation forms and time cards as documentation for paid employment)

Average scores in each area Total Hours Completed:

Quality of Work

Areas of Evaluation Paid Employment for school year Attitude/Cooperation

, semester

Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Paid Employment for school year

Average scores in each area Total Hours Completed:

Quality of Work

, semester Attitude/Cooperation Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Paid Employment for school year

Average scores in each area Total Hours Completed:

Quality of Work

, semester Attitude/Cooperation Teamwork

Productivity

Nature of Work Performed:

Areas of Evaluation Paid Employment for school year

Average scores in each area Total Hours Completed:

Quality of Work

, semester Attitude/Cooperation Teamwork

Productivity

Nature of Work Performed:

EMPLOYMENT INFORMATION
(Type or print all information)

Present Employer

Complete Name of Company or Person Complete Street Address

City Telephone Number Job Title Type of Work Performed:

State

Zip

to
Dates of Employment (MM/DD/YY)

,
Supervisors Name and Title

Previous Employer # 1

Complete Name of Company or Person Complete Street Address City Telephone Number Job Title Type of Work Performed: State Zip

to
Dates of Employment (MM/DD/YY)

,
Supervisors Name and Title

Previous Employer #2

Complete Name of Company or Person Complete Street Address City Telephone Number Job Title Type of Work Performed: State Zip

to
Dates of Employment (MM/DD/YY)

,
Supervisors Name and Title

EMPLOYMENT INFORMATION
(Type or print all information)

Previous Employer # 3

Complete Name of Company or Person Complete Street Address City Telephone Number Job Title Type of Work Performed: State Zip

to
Dates of Employment (MM/DD/YY)

,
Supervisors Name and Title

Previous Employer # 4

Complete Name of Company or Person Complete Street Address City Telephone Number Job Title Type of Work Performed: State Zip

to
Dates of Employment (MM/DD/YY)

,
Supervisors Name and Title

Previous Employer #5

Complete Name of Company or Person

Complete Street Address City State Zip

to
Telephone Number Job Title Type of Work Performed: Dates of Employment (MM/DD/YY)

,
Supervisors Name and Title

REFERENCE INFORMATION
(Type or print all information)

Reference # 1
First Name Middle Initial Last Name

Complete Street Address

City

State

Zip

Telephone Number

Relationship Middle Initial Last Name

Reference # 2
First Name

Complete Street Address

City

State

Zip

Telephone Number

Relationship

Reference # 3
First Name Middle Initial Last Name

Complete Street Address

City

State

Zip

Telephone Number

Relationship

Reference # 4
First Name Middle Initial Last Name

Complete Street Address

City

State

Zip

Telephone Number

Relationship

Document 19 2 Letters of Recommendation Document 21 Completed Resume Document 20 Verification of Work Hours, School, Community, and Paid