Interview

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Interviewee Name *

Your answer

Email *

Your answer

Age *
Choose
Race *
Hispanic/Latinx

White

Asian

American Indian/Alaska Native

Native Hawaiian/Other Pacific Islander

Black or African American.

Other

Gender *
Female

Male

Prefer not to say

Non-binary/ third gender

Other:

Do you have a job? *

Yes

No

if No, Why?

Your answer
How hard has it been to get into the jobs that you are
interested in? *
1 2 3 4 5 6 7 8 9 10

Extremely
Not hard at all
hard

How much effort have you put into searching for the jobs? *
1 2 3 4 5 6 7 8 9 10

Little to No
A lot of effort
effort

Do you believe that you need to work on your communication

skills for your job? *
Yes

No

Maybe

Do you believe that you need to work on your Interview skills

for your job? ( such as situational or behavioral based
interview questions) *
Yes

No

Maybe
How good are you in using verbal communication?
(straightforward language that is neither too flowery or too
simple) *
1 2 3 4 5 6 7 8 9 10

Very Bad Very Good

How good are you in using nonverbal communication?

(consists of body language and the cues that are given off
while listening to someone else speak) *
1 2 3 4 5 6 7 8 9 10

Very Bad Very Good

How good are you in using written communication?(Proper

spelling, grammar usage and a professional way of imparting
information ) *
1 2 3 4 5 6 7 8 9 10

Very Bad Very Good

Where have you learned your skills from? *

Family

Friends

Work

School

Other:
 How much are you concerned with the time it takes to get to
new job opportunities? *
1 2 3 4 5 6 7 8 9 10

Not Very Extremely

Concerned Concerned

Do you personally own a car? *

Yes

No

Any comments?
Your answer

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