• Name of employee:

  • What is the last date of employment with Boys & Girls Clubs of Kern County?

  • Work Site:

  • Duration of Employment:

  • Reason for leaving:

  • Please list any positive experiences during term of employment.

  • Please list any changes to the program, in your opinion, that would be beneficial (if any).

  • Would you consider working for the Boys & Girls Clubs of Kern County again in the future?

  • Add signature

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