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Employment Application
Note:
*
Denotes a required response.
Name:
*
Address:
City:
State:
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OR
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Zip:
Phone:
*
Do you have a valid driver's license?
*
Yes
No
Do you have dependable transportation?
*
Yes
No
Are you physically able to lift 50 pounds?
*
Yes
No
Are you able to pass a drug test?
*
Yes
No
Have you ever been convicted of a crime?
*
Yes
No
How many hours can you work weekly?
*
Are you available to work:
*
Day Shift
Evening Shift
Night Shift
Employment Desired:
*
Full-Time
Part-Time
Either Full or Part-Time
When are you available to start work?
Salary desired:
Are you currently employed?
*
Yes
No
May we contact your employer
*
Yes
No
Current employer contact information:
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