[Changes to the OE Background Questionnaire]
Background Information
Occupation Expert for: <Insert Occupation Title>
The goal of this project is to get accurate, up-to-date information on the occupation of <insert occupation title> from a diverse and representative set of experts in the field. Your answers to these questions will help us achieve this goal. Therefore, it is very important that you give accurate answers to these questions. Thank you for your assistance.
Please read each question carefully and mark your answer by putting an X in the box beside your answer or by writing an answer on the line provided. Please answer the following questions for the occupation of <insert occupation title>.
1. What is the title of your most recent job in this occupation? (Please print)
2. In your most recent job in this occupation, were you employed part-time or full-time? (Mark one box)
Part-time
Full-time
3. In your most recent job in this occupation, were you employed
by
(Mark one box)
Government
Private for-profit company
Non-profit organization, including tax-exempt and charitable organizations
Academic institution
Self-employed
Other (Please print) _______________________________________
4. How much combined experience do you have performing work in this occupation, supervising workers in this occupation, and/or conducting training or teaching educational courses related to performing the work in this occupation? (Mark one box)
Ten years or more
At least 5 years, but less than 10 years
At least 3 years, but less than 5 years
At least 1 year, but less than 3 years
Less than 1 year
Never worked in this occupation in any capacity.
5. How much experience do you have performing work in this occupation? (Mark one box)
Ten years or more
At least 5 years, but less than 10 years
At least 3 years, but less than 5 years
At least 1 year, but less than 3 years
Less than 1 year
Never performed work in the occupation
6. When were you last employed in this occupation? (Mark one box)
Currently employed in this occupation
Within the last 6 months
At least 6 months ago, but less than 1 year
One year or more ago
Never employed in this occupation
7. How much experience do you have supervising workers in this occupation? (Mark one box)
Ten years or more
At least 5 years, but less than 10 years
At least 3 years, but less than 5 years
At least 1 year, but less than 3 years
Less than 1 year
Never supervised workers in this occupation
8. When were you last a supervisor of workers in this
occupation?
(Mark one
box)
Currently a supervisor of workers in this occupation
Within the last 6 months
At least 6 months ago, but less than 1 year
One year or more ago
Never supervised workers in this occupation
9. How much experience do you have conducting training or teaching educational courses related to performing this occupation? (Mark one box)
Ten years or more
At least 5 years, but less than 10 years
At least 3 years, but less than 5 years
At least 1 year, but less than 3 years
Less than 1 year
Never served as a trainer/teacher for workers in this occupation
10. When were you last conducting training or teaching educational courses related to performing this occupation? (Mark one box)
Currently employed as a trainer/teacher of workers in this occupation
Within the last six months
At least 6 months ago, but less than 1 year
One year or more ago
Never served as a trainer/teacher of workers in this occupation
11. Are you male or female? (Mark one box)
Male
Female
12. In what year were you born? __ __ __ __
13. Are you Hispanic or Latino? (Mark one box)
Yes
No
14. What is your race? (Mark one or more boxes)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
15. Indicate the highest level of education that you have
completed
(Mark one box)
Less than a High School Diploma
High School Diploma – or the equivalent (for example, GED)
Post-Secondary Certificate – awarded for training completed after high school (for example, in agricultural or natural resources, computer services, personal or culinary services, engineering technologies, healthcare, construction trades, mechanic and repair technologies, or precision production)
Some College Courses
Associate’s Degree (or other 2-year degree)
Bachelor’s Degree
Post-Baccalaureate Certificate – awarded for completion of an organized program of study; designed for people who have completed a Baccalaureate degree but do not meet the requirements of academic degrees carrying the title of Master
Master’s Degree
Post-Master’s Certificate – awarded for completion of an organized program of study; designed for people who have completed a Master’s degree but do not meet the requirements of academic degrees at the doctoral level
First Professional Degree – awarded for completion of a program that
requires at least 2 years of college work before entrance into the program
includes a total of at least 6 academic years of work to complete, and
provides all remaining academic requirements to begin practice in a profession
Doctoral Degree
Post-Doctoral Training
Yes No
16. Are you deaf or do you have serious difficulty hearing? .........
17. Are you blind or do you have serious difficulty seeing even when wearing glasses? ...............................................................
18a. Because of a physical, mental, or emotional condition,
do you have serious difficulty concentrating, remembering, or making decisions? .................................................................
b. Do you have serious difficulty walking or climbing stairs? .....
c. Do you have difficulty dressing or bathing? .............................
19. Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such
as visiting a doctor’s office or shopping? ................................
Your Professional Certifications
1. Please write the names of job-related professional certifications that you have earned:
a.________________________________________________________________
b.________________________________________________________________
c.________________________________________________________________
d.________________________________________________________________
e.________________________________________________________________
Your Apprenticeship Certificates
2. Please write the names of job-related apprenticeship programs that you have completed:
a.__________________________________________________________
b.__________________________________________________________
c.___________________________________________________________
d.___________________________________________________________
e.___________________________________________________________
Your Association Memberships
Finally, we would like to know about the professional associations to which you belong.
1. Are you currently a member of the following job-related association(s)? (Please respond for each association listed.)
<association name> Yes No
<association name> Yes No
2. Please print the names of any other job-related associations to which you belong:
a.
b.
c.
File Type | application/msword |
File Title | Background Information |
Author | onet |
Last Modified By | Windows User |
File Modified | 2015-09-03 |
File Created | 2015-08-12 |