Agency Position
Salary
Reference
1. Job Description
2. Physical Requirements Weight/Reach % of
Time Adaptations Remarks
Carrying
Cleaning
Climbing
Collating
Dialing
Driving
Filing
Hearing
Holding
Indexing
Inserting
Lifting
Maintenance
Opening
Pulling
Pushing
Removing
Scheduling
Sitting
2. Physical Requirements Weight/Reach % of
Time Adaptations
Remarks
Sorting
Speaking
Stamping
Standing
Stapling
Threading
Turning Pages
Typing
Unfolding
Unlocking
Using Keyboard
(coding)
Walking
Weighing
Writing
3. Cognitive
Requirements
Level/Type
Recommendations
Education
Math
Problem Solving
Reading
Reasoning
Training
4. Site Evaluation
Dimensions Adaptations
Job Site
Desk
4. Site Evaluation Dimensions Adaptations
Door
Door Mechanism
Elevators
File Cabinets
Floor Covering
Obstacles
Steps
Threshold
Bathroom
Door
Grab Bars
Sink
Toilet
Cafeteria
Accessibility
Parking
5. Comments:
Operation of Equipment
Job Analyst Date
Reprinted with permission from the Job Development Bank and
Enhanced Productivity for Severely Disabled Persons, K. Mallik and S. Yuspeh,
1979, G. Washington University Rehabilitation Research and Training Center,
Washington, D.C., Grant # G008300123, NIDRR, Department of Education