Personal
Information *
Required Fields |
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First
Name: |
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Last
Name: |
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Your
E-mail: |
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*
Address: |
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Years
At This Address: |
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City: |
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Phone
Number: |
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Cell
Number: (optional) |
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Referred
By: |
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Contact
Type: |
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18
Years Or Older: |
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Desired
Employment |
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Driver
Telephone Reservation
Specialist
Ride Attendand
Other / Second Desired |
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Date
You Can Start: |
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Salary
Desired: |
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Are
You Employed Now ? |
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Education
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Grammar
School:
Name
& Location Of School
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Years
Attended: |
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High
School:
Name
& Location Of School
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Years
Attended: |
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College:
Name
& Location Of School
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Years
Attended: |
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Trade,
Business, Other School:
Name
& Location Of School
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Years
Attended: |
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Former
Employers |
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1.
Name & Address of Present
Employer: |
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Phone
Number: |
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May
we contact them: |
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Starting
Date: |
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End
Date: |
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Reason
for leaving: |
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2.
Name & Address of Past Employer:
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Phone
Number: |
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May
we contact them: |
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Starting
Date: |
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End
Date: |
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Reason
for leaving: |
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References |
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Reference
1
Name, Address, Phone |
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Reference
2
Name, Address, Phone
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Reference
3
Name, Address, Phone
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Service
Record |
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Military:
Branch
of Service and Discharge Date: |
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Please
list any Special Skills that would
be an asset to our company: |
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*
Have
you ever been convicted of a Felony
within the last 5
Years ? |
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If
"Yes" Please Explain
(
Will not necessarily exclude you
from consideration ) |
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*
Do
you have any medical conditions
that may inhibit your
performing certain duties ?
(i.e.:
lifting, standing,etc.) |
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If
"Yes" Please Explain
(
Will not necessarily exclude you
from consideration ) |
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Additional
Information ( Optional )
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If
you would like to include any
additional information
you may do so here. |
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APPLICANT'S STATEMENT
AUTHORIZATION
"I
certify that the facts contained
in this application are true
and complete to the best of
my knowledge and understand
that, if employed, falsified
statements on this application
shall be grounds for dismissal.
I
authorize investigation of all
statements contained herein
and the references and employees
listed above to give you any
and all information concerning
my previous employment and any
pertinent information they may
have, personal or otherwise
and release the company from
all liability for any damage
that may result from utilization
of such information.
I
also understand and agree that
no representative of the company
has any authority to enter into
any agreement for employment
for any specified period of
time, or to make any agreement
contrary to the foregoing, unless
it is in writing and signed
by authorized company representative."
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