Youth Job Connection

Service Plan Closure Form

23rd August, 2018
Date: ________________________________________

Nadeem Ahmed Khan

Client full name

YJC #

Reason for service plan closure

Outcome at the closure
(details on employment, education,
training, other)

Case related notes

Customer Satisfaction
General satisfaction with the Youth o I strongly do not recommend Youth Job Connection
Job Connection program o I would rather not recommend Youth Job Connection
o No general opinion
o I would generally recommend Youth Job Connection
o I strongly recommend Youth Job Connection
o No response
The Youth Job Connection program o Strongly disagree
prepared me to find and keep a job. o Somewhat disagree
o Neither agree nor disagree
o Somewhat agree
o Strongly agree
o Not applicable
The pre-employment service o Strongly disagree
workshops helped me improve skills I o Somewhat disagree
can use to find and keep a job. o Neither agree nor disagree
o Somewhat agree
o Strongly agree
o Not applicable
My job placement helped me gain o Strongly disagree
experience that I can use to find and o Somewhat disagree
keep a job. o Neither agree nor disagree
o Somewhat agree
o Strongly agree
o Not applicable
Is the participant skill working with the o Yes
placement employer? o No
o No response
o Not applicable

Program Worker Full Name and Signature: __________________________________________________

Created: November 9, 2015