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Submit the Application

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation.)
Yes
No
Are you 18 years or older?
Yes
No
Are you looking for full-time employment?
Yes
No
What is your shift preference?
1st
2nd
Are you willing to work overtime?
Yes
No
Do you have any obligations that would keep you from having regular and predictable attendance?
Yes
No
Have you missed any work or school in the past year?
Yes
No
Do you have any physical limitations that would impair your performance on the job applied for?
Yes
No
Have you ever been convicted of a crime other than minor traffic violations?
Yes
No
Have you ever applied for employment here or worked here through an agency?
Yes
No
Have you ever been employed by this company?
Yes
No
Do you have any friends or relatives that work here?
Yes
No
Are you presently employed?
Yes
No
May we contact your present employer?
Yes
No
Will you relocate?
Yes
No
Are you willing to travel?
Yes
No
Did you graduate?
Yes
No
Were/are you in Military service?
Yes
No

Employment History(Start with most recent employer)

Please list like this: Company Name ________________________________________________________________ Location_______________________________________Telephone ______________________ Position_______________________________________________________________________ Start Date_______________________________ End Date______________________________ Pay Rate______________________________________________________________________ Name of Supervisor _____________________________ May we contact?  Yes  No Responsibilities ________________________________________________________________ ______________________________________________________________________________ Reason for leaving ______________________________________________________________

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