I affirm that all information in this document is true and complete Any false statements, misrepresentations, or omission of facts called for, shall be grounds for refusal of employment or if hired, termination of employment. High School Information High School Attended: Attended From: Attended To:Ĭollege Information College Attended: Attended From: Attended To: College Major: Next Most-Recent Employer Business Name: Business Address: City: State: ZIP: Business Phone Number: Supervisor Name: Employed From: Employed To: Reason for Leaving: Previous Employment Most-Recent Employer Business Name: Business Address: City: State: ZIP: Business Phone Number: Supervisor Name: Employed From: Employed To: Reason for Leaving: Sun Total hours per week desired: Desired wage per hour: ![]() Sun Night shifts available (check all that apply) Management Please list skills that you consider valuable to this position(s) Day shifts available (check all that apply) Position & Availability Position(s) of Interest (check all that apply) Personal Information First Name: Middle Name: Last Name: Email: Address: City: State ZIP: Phone Number: Best time to call:
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