Employment Application

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    EDUCATION:

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    EMPLOYMENT

    List last employment first. Include summer or temporary jobs. Be sure all experience or employers related to that job are listed here, in the summary following this section.
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    REFERENCES:

    List two personal references who are not relatives or former supervisors.
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    IN CASE OF ACCIDENT OR ILLNESS PLEASE CONTACT:

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    EQUAL EMPLOYMENT OPPORTUNITY:

    While many employers are required by federal law to have an Affirmative Action Program, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposes only. This is optional and failure to provide it will have no effect on your application for employment.

    INFORMATION TO THE APPLICANT:

    As part of our purpose for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, subsequently hired, you may be discharged from your job. You may have a written request for information derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the US, have a physical examination and/or a drug test, or to sign a conflict of interest agreement and abide by its items. By submitting application you understand and agree to the information shown above.