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APPLICATION FOR EMPLOYMENT

Equal access to program, services and employment is available to all persons. Those applicants requiring accommodations to the application and/or interview process should contact a representative of the personnel department.


PLEASE PRINT

Full-Time Part-Time Temporary Seasonal Educational Co-Op
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AN EQUAL OPPORTUNITY EMPLOYER

EMPLOYMENT HISTORY

List your last four (4) employers, assignments or volunteer activities, starting with the most recent, including military experience. Explain any gaps in employment in comment section below.

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Educational Background (If job related)

List last three (3) schools attended, starting with most recent


List any foreign language(s) you know and check the boxes that describe your skill level






















References

List names of persons not related to you who are willing to provide professionals and/or character references


List professional, trade, business, or civic association and any office held. (Exclude membership which would reveal sex, race, religion, national origin, age, color, disability, or other protected status)

List special accomplishment, publications, awards (Exclude membership which would reveal sex, race, religion, national origin, age, color, disability, or other protected status)

It is understood and agreed upon that any mispresentation by me on this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed.

I give the employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the employer and it's representatives for seeking such information and all other persons, corporations for furnishing such information.

The employer is an Equal Opportunity Employer. The employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant's consideration for employment on a basis prohibited by local, state or federal law.

This application is current for only 60 days. At the conclusion this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that just as I am free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause and without notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand it is this cpmpany's policy not to refuse to hire a qualified individual with a disability because of this person's need for an accommodation that would be required by the ADA


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