EMPLOYMENT APPLICATION
Date:
Name:
Address:
City, State & Zip:
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AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
ME
MD
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
e-mail Address :
Are you over 18?
Yes
No
PRIOR WORK EXPERIENCE
(Please list most recent employment first.)
Job 1
Employer
Employer Address
Employer Phone
Position (duties)
Immediate Supervisor
Can we contact?
Yes
No
Starting Pay
Ending Pay
Dates Employed
from
to
Reason for leaving
Job 2
Employer
Employer Address
Employer Phone
Position (duties)
Immediate Supervisor
Can we contact?
Yes
No
Starting Pay
Ending Pay
Dates Employed
from
to
Reason for leaving
School
High School
# of years attended
Name of school
City
Course
Did you graduate?
Yes
No
College
# of years attended
Name of school
City
Major
Did you graduate?
Yes
No
Can you work on the weekend?
Yes
No
Years of Press Experience?
0
1-2
3-4
5 +
Years of Shipping Experience?
0
1-2
3-4
5+
Other Skills, Licenses?
Application for Employment
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