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Action Cuts Employment Application
Employment Application
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Email *
Name *
Full Name:  First, Middle, Last
Date of Application *
MM
/
DD
/
YYYY
Present Address *
Telephone *
Please enter your 10 digit phone number included dashes.  (xxx-xxx-xxxx)
If under 18, please list current age:
Position applied for *
Required
Hourly pay desired *
Please be specific.
Days available *
Required
How many hours can you work weekly? *
Can you work nights? *
Employment desired *
Educational History *
Please list all educational history, including a list of schools attended (name + address), # of years completed, and any major/degree.
Have you ever been convicted of a crime? *
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
Office Skills *
Please check any skills you have.
Required
References *
Please list two references other than relatives or friends.
Do you have a driver's license? *
What is your means of transportation to work? *
Please choose your main transportation to work.
License Type
Have you ever been in the Armed Forces?
Clear selection
Are you now a member of the National Guard?
Clear selection
Military History
Please list your specialty, date entered, and discharge date as appropriate.
Work Experience *
Please provide a list of work experience from most recent to least recent for the last 5 years.  Please include employer address, name of supervisor, dates of employment, salary, title, and reason for leaving.
Additional Information
Please summarize any additional information necessary to describe your qualifications for the specific position you are applying for.
May we contact your current employer? *
Did you complete this application yourself? *
A copy of your responses will be emailed to the address you provided.
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