Cooperative Education Exit Interview

Please answer the questions below regarding your full cooperative education assignment. Your answers are confidential and will not be shared with your employer.

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Name Name First Last
Student T Number (List as: T12345678)
TN Tech Email:
Major
Please select your Co-op Plan:

Please select your Co-op Plan: Plan A (up to 12 months or more) Plan B (Alternating Semesters) Plan C (Parallel work/school) Plan D (Summer Only)
How many semesters were you enrolled in Co-op?
Please list your Co-op Employer:
Please list the City/State of the employer location you worked:
Position Title:
Provide an overall description of your duties and tasks:
Please list your start date: Please list your start date: / MM / DD YYYY
Please list your end date: Please list your end date: / MM / DD YYYY
Please list your starting hourly wage: $ Dollars . Cents
Please list your ending hourly wage: $ Dollars . Cents