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October 26, 2014
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Kentucky Office of Employment and Training
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Job Contact Form
This form is to be used for the (KEN) Reemployment Services Program ONLY.  It is not to be used for the Unemployment Insurance Eligibility Review Program. You must report in-person at your local office for the Unemployment Insurance Eligibility Review Interview as directed and provide your job contact Information.

Last Name:  

First Name:

         
         
1. Date Contacted Employer Name Employer Address Person Contacted  
 
Emp. Phone Number Position Applied For Results    
   
         
2. Date Contacted Employer Name Employer Address Person Contacted  
 
Emp. Phone Number Position Applied For Results    
   
         
3. Date Contacted Employer Name Employer Address Person Contacted  
 
Emp. Phone Number Position Applied For Results    
   
         
4. Date Contacted Employer Name Employer Address Person Contacted  
 
Emp. Phone Number Position Applied For Results    
   
         
5. Date Contacted Employer Name Employer Address Person Contacted  
 
Emp. Phone Number Position Applied For Results    
   
         
6. Date Contacted Employer Name Employer Address Person Contacted  
 
Emp. Phone Number Position Applied For Results    
   

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