Loudoun County, Virginia
102 Heritage Way, N.E., Suite 103, PO Box 7400, Leesburg, VA 20177-7400
(703)777-0353 Voice (703)777-0109 FAX
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Loudoun County VIEW Program
Job Follow-Up Report
Please answer the following Questions:
Are you still employed?
Name of Employer
Average hours per week
Hourly rate of pay $
Date last worked
Are you having problems with any of the following?
If there is something that you would like to discuss with me, please indicate a time, date and telephone number where you may be reached or call me at the number shown at the top of the page.
I attended training/educational class/tutoring/living skills class. Please list the name of Course and Organization providing the instruction. (Employment & Training, JOBS, Public School, Community Mental Health, etc.)
I received services through a county or community agency. List name of Agency & Service provided.
Some information I would like to share (event that happened this month.)