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Name *
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Address *
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Phone
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Type of employment desired: *
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Date you will be available to start work:
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Are you able to meet the attendance requirements? *
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Do you have any objection to working overtime if necessary? *
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Can you travel if required by this position? *
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Have you ever been previously employed by our organization? *
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Can you submit proof of legal employment authorization and identity? *
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Are you over 18 years of age? *
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Employment History
Please provide all employment information for your past four employers starting with the most recent.
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Dates employed:
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We may contact the employers listed above, unless you indicate those you do not want us to contact.
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Other Skills and Qualifications
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Educational History
List school name and location, years completed, course of study, and any degrees earned:
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References
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I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. (With the exception of those I listed.) I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information.
I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered.
If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law.
I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA.
I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment.
I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.
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If the wall is white, what color is it?
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