Santa Rosa Junior College



EMPLOYEE OF THE MONTH QUESTIONNAIRE

|Name: | |

|Title: | |

|Department: | |

|Where were you born? | |

|Where did you grow up? | |

|Where did you graduate from high school? | |

|Where did you go to college? | |

|Degrees earned? | |

|Work experience prior to SRJC: | |

|When did you move to Sonoma County and why? | |

|When were you hired at SRJC? | |

|Jobs (with dates) held at SRJC: | |

|What are some of the key responsibilities of your| |

|job? | |

|Why do you believe you have been so successful in| |

|serving the college and students at SRJC? | |

|What do you believe is your greatest | |

|accomplishment at the college? | |

|What has been your greatest challenge? | |

|What do you like most about your job? | |

|What would people be surprised to learn about | |

|your job (i.e. something you do that people | |

|wouldn’t normally associate with your job | |

|description)? | |

|Committee Volunteer work at SRJC: | |

|Community activities: | |

|Hobbies and/or interests: | |

|Family: | |

|What was your reaction to being named Employee of| |

|the Month? | |

|Any additional comments you would like to share: | |

|We would like to include your picture (the same one that will be used for the Insider article) with the Employee of the Month article we will |

|post to our website, but we would like to have your permission before we do so. |

|( Yes, it’s fine to use my picture on your website. |

|( No, I would rather you did not use my picture. |

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