Statement of Duties Feedback Job # or Grievance # or Job Title * First Name * Last Name * Would you like to receive a copy of this form at your email address? * Yes No Home Email Address * Home Email Address Section 3 – Client Service Results Section 4 – Key Activities Section 5 – Skills Section 6 – Effort Section 7 – Responsibilities Section 8 – Working Conditions Section 9 – Additional Information If you are human, leave this field blank.