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Careers – Internship – Office

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Name*
Address*
REFERENCES: Give below the names of three (3) persons not related to you whom you have known at least one (1) year.
Reference #1*
Reference #2
What days are you available?
EMPLOYMENT DESIRED:
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Are you employed?*
If so may we contact your current employer?*
Have you ever applied to this company before?*
EDUCATION HISTORY:
Name and Location of High School*
High School Graduate?*
SPECIAL SKILLS
PAST EMPLOYMENT – List all employment including military for the past (5) years beginning with your present or last job held.
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Address
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Address
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Address
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Address
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Address

BACKGROUND INFORMATION

When completing this information do not disclose information regarding convictions that have been judicially sealed, expunged, eradicated, impounded, or dismissed. Do not disclose information regarding juvenile court convictions. A conviction record does not automatically bar you from employment. All of the job-related circumstances surrounding convictions will be considered.
In the last 7 years, have you been convicted of, pled guilty or no contest to, been imprisoned, or on probation or parole for any felony?*
In the last 7 years, have you been convicted of, pled guilty or no contest to, been imprisoned, or on probation or parole for any misdemeanor?*
Do you currently have charges pending?*
Are you currently on probation?*
Have you ever been dismissed, or asked to resign from employment or contracted work?*
Do you have any traffic violations on your record for the past 3 years?*
Max. file size: 50 MB.
All information provided will be held in the strictest of confidence.
I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above. Furthermore, I understand that if I am hired, employment with this company is “at will,” which means that either the company or I can terminate my employment for any reason not prohibited by state or federal law.
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