i>>/ < <R0MPwid::{шvѺ`@!~ɏB$ ԙR88 88 @ "  @ @ @ } @ Li 0  @@@ ,   rF ^U J> V]&4 L Nf $7 MS  B 7  >  ; o3Ld @}2  kZ 3L  MS @ @/? 0/0 - `_H?DISPLAYDISPLAYNone``@@xGMM(xKdContents^tIndex ,^>;^>^=.^>, C:\ALDUS\UKENGLSH:\ALDUS\UKENGLSH\PM5.HLPxA77 ..--__'(#(  t t &f 0- 0- S}0- EmaculateCommunicatio! !  creditcardpayment.  Times New Roman$Arial"$bjec(xKdxGMMBody text(xKddGMMCaption(xKdxGMMHanging indentU(xKd,GMMHeadlineU(xKdGMMSubhead 1U(xKdxGMMSubhead 2"dd(xKdxGMMNormal"rsuanttostatuteor  : regulation,orotRegistrationPaperBlackRedGreenBlueRTFColor11theexclusionofthecourts. -~ ?- -atedtoanyClaimand,where /0*--youalsoagreetooptoutofany    0*E@ U#0*@@0*#@ X0*@@0*30 0*E@ U#0*@@0*#@ 0*@@0* 0*D@ U#0*@@0*9PP_0*@@0*>P  0*@@0*M8 '0*P  0*@@0* P 0*@@0* @ 0*@@0* x0*L@ (#0*@@0*!@ +0*@@0*B@ "0*@@0* @ f0*@@0* x0*L@ (#0*@@0*!@ +0*@@0*B@ "0*@@0*P / 0*@@0* x0*L@ (#0*@@0*!@ +0*@@0*B@ "0*@@0*d0 )0* A 0*C "0*C@ "0*@@0*H@ #0*@@0*LP "0*@@0*F@ F#0*@@0*D@ U#0*@@0*5@ %0*@@0*H@ "0*@@0*:P Z0*@@0*5P 0*@@0*GP #0*@@0*M@ F#0*@@0*E@ "0*@@0*GP #0*@@0*M@ F#0*@@0*E@ "0*@@0*GP #0*@@0*M@ F#0*@@0*E@ "0*@@0*R0 )0*N0 0*0*. 0* 0*KP '0*@@0*J'"xbFřkdh1MB+NAME (Last, First, Middle) ___________________________________________________________________ SOC. SEC. # ______________________ ADDRESS (Number and Street, City, State, Zip Code) ___________________________________________________________________ PHONE NO. (____)__________________ POSITION DESIRED___________________________________________________________________ Full-time ________ Part-time ________ Temporary ________ HAVE YOU WORKED FOR THIS COMPANY BEFORE? Yes ______ No ______ IF YOU ARE A MINOR UNDER AGE 18, DO YOU HAVE A CERTIFICATE OF AGE OR EMPLOYMENT? Yes ______ No ______ EDUCATION High School NAME AND ADDRESS OF SCHOOL ___________________________________________________________________________ MAJOR __________________________ DEGREE/DIPLOMA __________________________________________________ College NAME AND ADDRESS OF SCHOOL ___________________________________________________________________________ MAJOR __________________________ DEGREE/DIPLOMA __________________________________________________ Trade, business, other school NAME AND ADDRESS OF SCHOOL ___________________________________________________________________________ MAJOR __________________________ DEGREE/DIPLOMA __________________________________________________ SPECIAL SKILLS AND QUALIFICATIONS: List job-related licenses, skills, training, honors, awards, and special accomplishments____________________________________________________________________________________________________________________________________ Supervisor: ____________________________ Phone: _______________________ Position Title: __________________________ From: __________ To: ___________ Duties: _____________________________________________________________ ___________________________________________________________________ Salary: (first)_______________ (last)_______________ Reason for leaving: ___________________________________________________ MAY WE CONTACT YOUR PRESENT EMPLOYER? Yes _____ No _____ REFERENCES: (EXCLUDE RELATIVES AND FORMER EMPLOYERS) 1. Name/Title ________________________________________________________ Address and Phone No. ______________________________________________________ Occupation _________________________________________________________ 2. Name/Title ________________________________________________________ Address and Phone No. ______________________________________________________ Occupation _________________________________________________________ 3. Name/Title ________________________________________________________ Address and Phone No. ______________________________________________________ Occupation _________________________________________________________ I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT ANY FALSE INFORMATION ON THIS APPLICATION MAY BE GROUNDS FOR NOT HIRING ME.DATE________________SIGNATURE_____________________________________________ zUT.r#T>Vmqkdhx ^xGMMxGMM"xGMMxGMMvxGMMxGMM"xGMMxGMMTxGMMxGMM%xGMMGMMxGMMxGMM=xGMMxGMMRxGMMxGMMxGMMxGMM xGMMxGMM xGMMxGMMxGMMxGMMNxGMM xGMMxGMMAxGMMxGMMxGMMxGMMxGMMxGMMNxGMM xGMMxGMMAxGMMxGMMxGMMxGMMxGMMNxGMM xGMMxGMMAxGMMxGMMxGMMxGMMGxGMMxGMMKxGMMxGMMExGMMxGMMCxGMMxGMM4xGMMxGMMGxGMMxGMM%xGMMxGMMxGMMxGMM xGMM)xGMMxGMMxGMMxGMMCxGMMxGMMxGMM8xGMMDxGMMxGMMxGMMxGMMCxGMMxGMMxGMM8xGMMDxGMMxGMMxGMMxGMMCxGMMxGMMxGMM8xGMMDxGMMxGMMxGMMxGMMʩMFB ;GXGwV qǤ "dd(xKdT@q$""q,Y.sy# h-tGp5^ (p@ P !$`'0*-/2p5@8;=@CPF IKNQ`T0WZ\_pb@ehjmpA9s0M̝X0`޿Iv0* H a=w 'r#:T:ɧG.;ſ@ 0*R'$0*6P f0*,P L0*@ D0*@ 0*@ 0*UxĊkH;] EMACULATE COMMUNICATIONS Enter the information into the provided space below. Type or print clearly in black or blue ink. Answer all questions g5J< b)"ffxsxGMM,GMM~xGMM)A0T/!N̫9oTF{w(xKd(xKd}(xKdR)B#eafICZjx4Pb!D@J^   %% ((@ ^  _@, 7 8 8 9 9 @: : ;