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Employment Application
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APPLICANT INFORMATION
Last Name Street Address City Phone Date Available Position Applied for Are you a citizen of the United States? Have you ever worked for this company? Have you ever been convicted of a felony?** YES YES YES NO NO NO If no, are you authorized to work in the U.S.? If so, when? If yes, explain YES NO State E-mail Address Last 4 digits of SSN Desired Salary First M.I. Date

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