DuMor Water Specialists Job Application Form

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We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job functions.

Name (First Name, Middle Initial, Last Name) *

Address (Street, City, State, Zip) *

Social Security Number *

Date of Birth *

YYYY

Email Address *

Phone number *

Which position(s) are you interested in? *

Customer Service/Front Counter - Full Time

Water Consultant/Sales - Full Time

Service Technician - Full Time

Routes Delivery Driver - Full Time

Service Department Manager - Full Time

Service Dispatch Coordinator - Full Time

Angola Store Associate - Part Time

Required

Tell us about yourself; why you would like to be considered for a position at DuMor Water Specialists, Inc.? *

Do you have any relatives who are presently (or have formerly been) employed by DuMor Water Specialists, Inc.? If so who? *

Is there any information we would need about your name or use of another name that would enable us to check your work record? Please Specify: *

How were you referred to DuMor Water Specialists, Inc.? *

Have you ever been convicted of a felony? *

Yes

If Yes, please explain: *

Have you ever been bonded? *

Yes

Are you eligible to be bonded? *

Yes

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