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Employment

Applicant Information

Full Name
Date of Application
Address (City, State, Zip Code)
Telephone Number
Email Address

Employment Position

Applying For:
How Did You Hear About This Position?
What Days Are You Available For Work?
What Hours or Shifts Are You Available to Work?
On What Date Can You Start Working If You Are Hired?
November 2019
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Do You Have Reliable Transportation To And From Work?

Personal Information

Have You Ever Applied To Work For Itavie Before?
If You Have Applied, When?
Do You Have Any Friends, Relatives, or Acquaintances Working For Itavie?
If Yes, State The Name and Relationship
Are You 18 Years of Age or Older?
Are You A U.S. Citizen or Approved to Work in the United States?
What Document Can You Provide as a Proof of Citizenship or Legal Status?
Will You Consent To a Mandatory Controlled Substance Test?
If Yes, Please Describe Accommodations Required Below
Have You Ever Been Convicted of a Criminal Offense? (Felony or Misdemeanor)
If Yes, Please State the Nature of the Crime(s), When Convicted, and Disposition of the Case

Requested Information

Do You Have Any Conditions Which Would Require Job Accommodations?

Job Skills/Qualifications

Please List Below the Skills and Qualifications You Possess for the Position for Which You Are Applying For

Education and Training

High School (Name, Address, Year Graduated, Degree Earned)
College/University (Name, Address, Year Graduated, Degree Earned)
Vocational School/Specialized Training

Military

Are You A Member of The Armed Forces?
What Branch of the Military Did You Enlist?
What Was Your Military Rank When Discharged?
How Many Years Did You Serve in the Military?
What Military Skills Do You Possess That Would Be An Asset For This Position?

First Employer

Employer Name:
Job Title:
Supervisor Name:
Employer Address: (City, State, & Zip Code)
Employer Telephone:
Dates Employed:
Reason For Leaving:

Second Employer

Employer Name:
Job Title:
Supervisor Name:
Employer Address: (City, State, & Zip Code)
Employer Telephone:
Dates Employed:
Reason For Leaving:

Additional Information

Notes: