WPC4 J敚yjQܑ>kV0` A29Ѽ( p=4]--/+[:'(7U%T + ̷t@6-wO~L8ޗOnN?]`_+mH {e<+Y */͌y omc[86-f܈ml!U"e=5T)Y4ŞGIqٝQWqEEV Z1線pO5sLС6 m$r9_pw&`*!b\SRY %X\% RE5I]po%+y^`if1])Qg $v CbB8!;J LIAgVNl C 埘}ԏBR\Y(h*LPr(E9gU\B % 0 0 0 0t 0Z 0 j 0V 02 0\ 0^jU8. 0 B* D3 0 0=# 0 ` A S4L E Q X!f!t!!UB$ $ $ $$$$$$ %%(%(%(%(%(%9?&?&x((((((((((#(( **'*5*C*Q*Q*n+|+++++++,,,+,..,.:.H.V.d.r.....n. 0f2#!(3NI4^ K4w@W4444 m4U:4\  `*Times New RomanTT'   EMPLOYMENT APPLICATION 2 Admin0Karen .   H 4heading 1heading 1&    XXXW\  `*Times New RomanTTW        W\  `*Times New RomanTTW'    H 4heading 2heading 2&    XXXW\  `*Times New RomanTTW        W\  `*Times New RomanTTW'    H 4heading 3heading 3&    XXXW\  `*Times New RomanTTW        W\  `*Times New RomanTTW'    h:Default ParaDefault Paragraph FontXXXW\  `*Times New RomanTTW        W\  `*Times New RomanTTW8 ,TitleTitle  W\  `*Times New RomanTTW        W\  `*Times New RomanTTW  H 4Body TextBody Text  XXXW\  `*Times New RomanTTW        W\  `*Times New RomanTTW  <AT .headerheader   XXhx (#%         >4X` hp x (#>  <AT .footerfooter   XXhx (#%         >4X` hp x (#>  P8page numberpage numberXXXW\  `*Times New RomanTTW        W\  `*Times New RomanTTWP} 8Body Text 2Body Text 2  XXXC%2A`ArialTTC        W\  `*Times New RomanTTW  %2A`ArialTT  t)[A[A[A  _XX   *XXhx (#%X*       XX[AXXXX        [AXXԄ@    1  A  Ԁ     [A[A[A[A   X      ' XXXhx X'    H4XX` hp x (#%XH(Y2t$ ^Y![A[A[A  &0 d d'dxd Level 1 Level 2 Level 3 Level 4 Level 5(Y2t$ ^Y![A[A[A  ($    (Y2t$ ^Y![A[A[A  E<< c  t"[A[A[A  _( [A~( H4XX` hp x (#%XHXc X~ t"[A[A[A  _XX[AXc XXXH4XX` hp x (#%XHText1 t"[A[A[A  XX[AXc XXX XX%XH4XX` hp x (#%XX(#HCheck1Check2Check3  t) [A [A[A  _XX   *XXhx (#%X*        XX[A XXXX         [AXXԄ@    1  A  Ԁ      [A[A [A[A   X      ' XXXhx X'    H4XX` hp x (#%XH\  `*Times New RomanTTText5Text6Text7Check4Check5Check6Check7  t"[A[A[A  _XX[AXc XXX XX%XH4XX` hp x (#%XX(#H / t"[A[A[A  _XX[AXc XXX0XXL!!%X0Z4XX` hp x (#%XXL!!Z EMPLOYMENT/WORKEXPERIENCE: Startwithyourpresentormostrecentposition.Includemilitary  serviceassignmentsandvolunteeractivities.Excludeorganizationnamesthatindicaterace,color,religion,sexornationalorigin.Text16Text17Text18Text19Text20Text23Text24Text25  t"[A[A[A  _XX[AXc XXX$XX %X$N4XX` hp x (#%XX ` NText27Text28Text29Text30Text31  t"[A[A[A  _XX[AXc XXX! XX%X!K4XX` hp x (#%XX KText33Text34Text35Text36Text37 t"[A[A[A  XX[AXc XXX XX%XH4XX` hp x (#%XX(#HText39Text40Text41 ! t"[A[A[A  XX[AXc XXX<(X XFhp x (#%X<N4XX` hp x (#%XXFhXNText42Check8Check9Check9Text46Text47Text43Check10Check11Text44Text453|x1 \  `*Times New RomanTTC\  P6QP\  `*Times New RomanTTXXP\  P6QXP\  `*Times New RomanTTy\  P6QP%2A`ArialTTomanTTXXX2PQXP%2A`ArialTTomanTT2PQP%2A`ArialTTomanTT2PQP(>Y$[A[A[A0#n/  (E)U*D+E,-E.U/01D}}-"U.SAZ"Arial Regular ^Y![A[A[A  _XX[A XXXc XXXfXc X XXcXXXX0000  f~ XfXc( f~      XX( fXc XXX 11#fp XfXci#f 7C !fpEMPLOYMENTAPPLICATION#fp !f 7CF#fXc Xfp  X Z^    fXc X XfXcfXc X XfXc    M=9z X (# p @ H@EX(#(#X(#&   9   fXc X XfXcXX XfXc      fXc XXX  ^    fXc X XfXcfXc X XfXc'    Applicationsareconsideredwithoutregardtorace,color,religion,sex,nationalorigin,age,maritalor D veteranstatus,orthepresenceofanonjobrelatedmedicalconditionorhandicap.M=9z X (# p @ H@EXx(#(#Xx(#&   x    fXc X XfXcXX XfXc      fXc XXX  ^    fXc X XfXcfXc X XfXc'x    PERSONALINFORMATION:   + &    fXc X XfXcXX XfXc      fXc XXX  Date:  Ԁ____________________________0  StartDate :________________________________k  %% '^    fXc X XfXcfXc X XfXc'} 7          qFullTimeq#fp XfXc#fXc Xfp#Xc X XfXc#fXc X XXc    ԀPartTime    Ԁq#Xc X XfXc #fXc X XXc#fp XfXcj #fXc XfpԀTemporaryReferralSource__________________________________ G    Name:________________________________________________________________________&    fXc X XfXcXX XfXc      fXc XXX   BusinessName:________________________________ ! FormofEntity:_____________________ "     C ^    fXc X XfXcfXc X XfXc'S     StreetAddress:____________________________________Phone:______________ # _________  City/State/Zip:______________________________________SSN_:_________________________Haveyoueverbeenconvictedoforchargedwithafelonyormisdemeanor:q#fp XfXcu #fXc Xfp#Xc X XfXc3 #fXc X XXc &  & ԀYes '  ' Ԁq#Xc X XfXc#fXc X XXc#fp XfXc#fXc XfpԀNoIfyes,please q explaindetailsinfull,includingdates,detailsofoffense(s)charged,jurisdictionanddispositionofcase:______________________________________________________________________________________________________________________________________________________________#fp XfXc#fXc Xfp#Xc X XfXcQ#fXc X XXc ; _______________________________________________________________________________#Xc X XfXcM#fXc X XXc#fp XfXc #fXc Xfp ) _______________________________________________________________________________#fp XfXc5#fXc Xfp#Xc X XfXc#fXc X XXc o Haveyou,oranypersonorentitywithwhomyouhavebeenassociatedwith,filedforbankruptcy,beendeclaredbankruptorinsolventorbeenthesubjectofanyreceivershipproceedingswithinthelast7years? )  ) q#Xc X XfXc#fXc X XXc#fp XfXc#fXc XfpԀYes *  * q#fp XfXc#fXc Xfp#Xc X XfXce#fXc X XXcԀNo  IfYes,pleaseprovidefulldetails,includingdates,places,amountsinvolvedanddisposition:______________________________________________________________________________________________________________________________________________________________#fp XfXc #fXc Xfp#Xc X XfXcO#fXc X XXc  _______________________________________________________________________________#Xc X XfXc#fXc X XXc#fp XfXc#fXc Xfp  u  +M=9z X (# p @ H@EX"(#(#X"(#&    "Q "   fXc X XfXcXX XfXc      0fXc XXX  0^    XXXXfXc XXX' "    EDUCATION:  $h"$ &    fXc X XfXcXX XfXc      fXc XXX  Schools/CollegesAttended:  0 h 0h%h%0%%0p%%#Years0 p%p%YearGrad Degree &P$& % % ^    fXc X XfXcfXc X XfXc'&,    _____________________________________________0 p _________0 p%p%_________0 % %_________'>%' % % _____________________________________________0 p _________0 p%p%_________0 % %_________#fp XfXc#fXc Xfp#Xc X XfXc#fXc X XXc(,&( % % _____________________________________________0 p _________0 p%p%_________0 % %_________#Xc X XfXc#fXc X XXc#fp XfXcw#fXc Xfpr)') % % _____________________________________________0 p _________0 p%p%_________0 % %_________#fp XfXc#fXc Xfp#Xc X XfXc#fXc X XXc`*(* % %  _____________________________________________0 p _________0 p%p%_________0 % %_________#Xc X XfXc #fXc X XXc#fp XfXc #fXc XfpN+(+ % % 0M=9z X (# p @ H@EXX(#(#XX(#&     X   fXc X XfXcXX XfXc      fXc XXX   Employer: #______________________________________________________________________"^    fXc X XfXcfXc X XfXc'X"    &    fXc X XfXcXX XfXc      fXc XXX   JobTitle:_____________________________ 2 Supervisor: 3 {%Ԁ________________________________$^    fXc X XfXcfXc X XfXc''$    &    fXc X XfXcXX XfXc      fXc XXX  StreetAddress:__________________________________________________________________ 4 I'     City/State/Zip:______________________________________ 5 Phone: 6 'Ԁ_______________________  DescribeDuties/Responsibilities/Accomplishments:______________________________________ i(&^    fXc X XfXcfXc X XfXc' &       ______________________________________________________________________________&    fXc X XfXcXX XfXc      fXc XXX   ReasonforLeaving:______________________________________________________________ 9 *  c  )^    fXc X XfXcfXc X XfXc' )    DatesofEmployment(Month/Year):From______________________ : To ; _____________________ Q  Employer:______________________________________________________________________&    fXc X XfXcfXc X XfXcXX XfXcXXXX      #Xc XXX!#fXc X XXc   JobTitle:_____________________________ 2 Supervisor: 3 -Ԁ________________________________,^    fXc X XfXcfXc X XfXcfXc X XfXcfXc X XfXc's,    &    fXc X XfXcfXc X XfXcXX XfXcXXXX      #Xc XXXz-#fXc X XXc  StreetAddress:__________________________________________________________________ 4 0 O   City/State/Zip:______________________________________ 5 Phone: 6 0Ԁ_______________________  DescribeDuties/Responsibilities/Accomplishments:______________________________________ 31 /')    fXc X XfXcfXc X XfXc'O/ +     ______________________________________________________________________________&    fXc X XfXcfXc X XfXcXX XfXcXXXX      #Xc XXX/#fXc X XXc   ReasonforLeaving:______________________________________________________________ 9 3  2^    fXc X XfXcfXc X XfXcfXc X XfXcfXc X XfXc'2    DatesofEmployment(Month/Year):From______________________ : To ; _____________________  #fp XfXc "#fXc Xfp#Xc X XfXc3#fXc X XXcEmployer:______________________________________________________________________&    fXc X XfXcfXc X XfXcXX XfXcXXXX      #Xc XXX 6#fXc X XXc   JobTitle:_____________________________ 2 Supervisor: 3 7Ԁ________________________________}6^    fXc X XfXcfXc X XfXcfXc X XfXcfXc X XfXc'6    &    fXc X XfXcfXc X XfXcXX XfXcXXXX      #Xc XXXg7#fXc X XXc  StreetAddress:__________________________________________________________________ 4 : C   City/State/Zip:______________________________________ 5 Phone: 6 :Ԁ_______________________  DescribeDuties/Responsibilities/Accomplishments:______________________________________  ;8')    fXc X XfXcfXc X XfXc'9 w     ______________________________________________________________________________&    fXc X XfXcfXc X XfXcXX XfXcXXXX      #Xc XXX9#fXc X XXc   ReasonforLeaving:______________________________________________________________ 9 = S  <^    fXc X XfXcfXc X XfXcfXc X XfXcfXc X XfXc'S <    DatesofEmployment(Month/Year):From______________________ : To ; _____________________ A! #Xc X XfXc|=#fXc X XXc#fp XfXc5#fXc Xfp&    fXc X XfXcXX XfXc      0fXc XXX  0@^    XXXXfXc XXX'/"(@    <M=9z X (# p @ H@EX/"(#(#X/"(#&   /"   fXc X XfXcXX XfXc      fXc XXX  A    fXc X XfXcfXc X XfXc'/"B    &    fXc X XfXcXX XfXc      fXc XXX   BUSINESSREFERENCES: Pleaseprovideindividualandcompanynames,position,addressesand :$!! phonenumbersfor3businessreferences. DSC    fXc X XfXcfXc X XfXc':$cC       fXc X XfXcXX XfXc      fXc XXX  Name:_________________________________________________________________________Company:_______________________________________________________________________0??US.,0 > 0US??.,0StreetAddress:___________________________________________________________________0??US.,0 ? 0US??.,0Position:_________________________________________________________________________0??US.,0 @ 0US??.,0 [E    fXc X XfXcfXc X XfXc    City/State/Zip:_______________________________________0??US.,0 A 0US??.,0Phone:_0??US.,0 B 0US??.,0_______________________ *p((    fXc X XfXcXX XfXc      fXc XXX  Name:_________________________________________________________________________Company:______________________________________________________________________ >  -:++ _StreetAddress:__________________________________________________________________ ? Position:________________________________________________________________________ @ City/State/Zip:______________________________________ A Phone: B Ԁ_______________________#fp XfXc?#fXc Xfp#Xc X XfXc?#fXc X XXcName:_________________________________________________________________________Company:______________________________________________________________________ > StreetAddress:__________________________________________________________________ ? Position:________________________________________________________________________ @ City/State/Zip:______________________________________ A Phone: B Ԁ_______________________#Xc X XfXcL#fXc X XXc#fp XfXcL#fXc Xfp I    fXc X XfXcfXc X XfXc    CM=9z X (# p @ H@EX (#(#X (#&    L    fXc X XfXcXX XfXc      fXc XXX  xP    fXc X XfXcfXc X XfXc' P       fXc X XfXcXX XfXc      fXc XXX  PERSONALREFERENCES: Pleaseprovidenames,addresses,phonenumbers,relationshipand  W  howlongknownfor3personalreferences.Name:??US.,_________________________________________________________________________Relationship:____________________________________________________________________ E US??.,StreetAddress:___________________________________________________________________0??US.,0 F 0US??.,0Howlong:_______________________________________________________________________0??US.,0 G 0US??.,0 Q    fXc X XfXcfXc X XfXc    City/State/Zip:_______________________________________0??US.,0 H 0US??.,0Phone:_0??US.,0 I 0US??.,0______________________ = Name:??US.,_________________________________________________________________________Relationship:____________________________________________________________________ E US.,??.,VStreetAddress:__________________________________________________________________ F Howlong:______________________________________________________________________ G City/State/Zip:______________________________________ H Phone: I Ԁ______________________#fp XfXcPO#fXc Xfp#Xc X XfXcO#fXc X XXcName:??US.,_________________________________________________________________________Relationship:____________________________________________________________________ E US.,??.,jYStreetAddress:__________________________________________________________________ F Howlong:______________________________________________________________________ G City/State/Zip:______________________________________ H Phone: I Ԁ______________________#Xc X XfXcDY#fXc X XXc#fp XfXcY#fXc Xfp M=9z X (# p @ H@EXS (#(#XS (# S   SPECIALSKILLS: Describeanyspecialskillsorqualificationsforthiswork: j" " ??US.,US??.,______________________________________________________________________________________________________________________________________________________________#fp XfXc[#fXc Xfp#Xc X XfXc[#fXc X XXc R$!$ _______________________________________________________________________________#Xc X XfXc^#0fXc X XXc0#p XXc]#??.,US.,]Xc Xp0#Xc X XfXca#0fXc X XXc @%"% US??.,______________________________________________________________________________________________________________________________________________________________#fp XfXc$_#fXc Xfp#Xc X XfXcp_#fXc X XXc '$' _______________________________________________________________________________#Xc X XfXc`##p XXcx`#??.,US.,_Xc XpfXc X XXc  (%( #fp XfXca#fXc Xfp#Xc X XfXca#fXc X XXcLM=9z X (# p @ H@EX((#(#X((#&   (&)   fXc X XfXcXX XfXc      fXc XXX  b    fXc X XfXcfXc X XfXc'(c       fXc X XfXcXX XfXc      fXc XXXICERTIFYthattheaboveanswersaretrueandcompletetothebestofmyknowledge.Iauthorize +(+ _______________________ M ,toinvestigateanystatementcontainedinthisapplication,andtoobtainacreditreportonme(andmycompanyifthisapplicationisforresellingbyacompany)asnecessarytodeterminemyqualifications.Iunderstandthatthisapplicationisnotandisnotintendedtobeanykindof -u+. contractoragreement.Intheeventofemployment,Iunderstandthatanyfalseormisleadinginformationgiveninmyapplication,correspondence,discussionsorinterviewmayresultinimmediatetermination.Iunderstandalso,thatIamrequiredtoabidebyallrules,regulationsandpoliciesof______________________ N .   Yd    fXc X XfXcfXc X XfXc    &    fXc X XfXcXX XfXc      fXc XXX  Signed:________________________________________________ Ki  h    fXc X XfXcfXc X XfXc'h    Date:______________________________ O   PM=9z X (# p @ H@EX(#(#X(#&      fXc X XfXcXX XfXc      fXc XXX  k    fXc X XfXcfXc X XfXc''k    FOR________________ Q ԀUSEONLY:     ArrangeInterview: R  R ԀUS??.,q??.,US.,l#Xc X XfXcUb#fXc X XXc#fp XfXcb#fXc XfpԀYesUS??.,q??.,US.,m#fp XfXcm#fXc Xfp#Xc X XfXcBm#fXc X XXcԀ S  T ԀNoDate:__________________ U Place:____________________ V   u     fXc X XfXcXc X XfXc      fXc X XXcRemarks: W ________________________________________________#Xc X XfXc@n#fXc X XXc#fp XfXcm#fXc Xfp_______________________ Q   n    fXc X XfXcfXc X XfXc    _______________________________________________________________________________(() ?  _____________________________________________________________________________________________________________________________________________________________)+)_)+,_,++**+  ̀   O Ѐ  +--..Approved: X  X US??.,q??.,US.,r#Xc X XfXco#fXc X XXc#fp XfXc+p#fXc XfpԀYes Y  Y ԀUS??.,q??.,US.,s#fp XfXcjs#fXc Xfp#Xc X XfXc(s#fXc X XXcԀNoDate:____________________ Z  = By: [ US??.,#Xc X XfXc?t##p XXcs#/_______________________________________________________/