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The following questions are to insure EEOC compliance and are strictly voluntary. We maintain this data for EEOC inquiries and to assist in any discrimination investigations by the federal, state and local governments.
Gender
Male
Female
X
Ethnicity
American Indian or Alaskan Native
Asian
Hispanic or Latino
Black or African American
White
Native Hawaiian or other Pacific Islander
Two or more races
Upload Resume
Attach a file
First Name
Last Name
Email
Address
City
State
Zip Code
Home Phone
Cell Phone
Do you have a valid drivers license?
YES
NO
Special Endorsements
Are you at least 18 years of age?
YES
NO
Can you provide ID to prove your identity and your legal right to work in the USA?
YES
NO
Are you willing to take a drug test?
YES
NO
Are you willing to submit to a background investigation?
YES
NO
Have you been convicted of a felony in the past seven years?
YES
NO
Are you currently employed?
YES
NO
Last Employer Name & Phone #
What is the minimum wage you will accept?
How many days a week are you willing to work?
Do you have transportation to and from work?
YES
NO
Are you seeking full or part time employment?
Please list the type of work you are qualified to peform.
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