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Career Placement Form

Date:  

Graduation Date:  
Student ID:

NAME:  

Bismarck/Mandan Address:  
P.O. Box #:
CITY:   STATE:   ZIP:  
PHONE #:

PERMANENT E-mail Address:

HOME TOWN ADDRESS:
CITY:   STATE:   ZIP:   PHONE #:

CONTACT PERSON: (Someone who has a phone and will know how to contact you.)
Name:   Phone #:
Name:   Phone #:

ARE YOU PRESENTLY EMPLOYED, IF SO, FILL IN BELOW:
Name of Employer:  
Phone:
Address:  
City/State/Zip:
Position:   Starting Date:  
Starting Wage:

IF GOING ON TO HIGHER EDUCATION, Please fill in below:
College Name:  
Accepted:   Yes   No
Address:  
Telephone:

If not employed or going on to higher education, what are you plans?


By clicking the Submit button, you agree to authorize the release of any
information pertaining to your employment or higher education placement.


Contact Us

Career Development Center
3315 University Drive
Bismarck, ND 58504

Nils Landin III
(701) 255-3285 ext. 1333

Rhonda Breuer
(701) 255-3285 ext. 1240

careers@uttc.edu