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Name:
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email:
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Best Telephone:
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Present Address:
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No. Street
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City State Zip
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Previous Address:(If different from Present Address)
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No. Street
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City State Zip
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Position applying for:
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If Other, enter description:
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Are you at least 18 years old?
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Yes
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No
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(If under 18, hire is subject to verification that you are of minimum legal working age.)
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If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?
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Yes
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No
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Have you ever been convicted of a criminal offense (felony or serious misdemeanor)? (Convictions for marijuana-related offenses more than two years old need not be listed.)
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Yes
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No
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If yes, state nature of crime(s), when and where convicted and disposition of the case(s):
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(Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
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Are you currently employed?
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Yes
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No
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If yes, may we contact your employer?
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Yes
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No
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Education, Training and Experience
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School
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Name and Address
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No. of Years Completed
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Did you Graduate?
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Degree or Certifications
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High School
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Yes
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No
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College/ University
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Yes
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No
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Vocational/ Business
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Yes
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No
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Many of our customers (clients) do not speak English. Do you speak, write or understand any foreign languages?
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Yes
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No
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If yes, which language(s)?
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Do you have any other experience, qualifications or skills which you feel make you especially suited for work at Lund Pearson McLaughlin? If so, please explain:
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Employment History
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List below all present and past employment starting with your most recent employer (last 3 years is sufficient). Account for all periods of unemployment. You must complete this section even if attaching resume.
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Name of Employer:
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No. Street City State Zip
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Type of Business:
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Telephone No.
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Supervisor's Name:
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Position and Duties:
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Date of Employment:
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From
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To
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Reason for Leaving:
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Name of Employer:
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No. Street City State Zip
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Type of Business:
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Telephone No.
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Supervisor's Name:
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Position and Duties:
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Date of Employment:
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From
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To
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Reason for Leaving:
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Name of Employer:
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No. Street City State Zip
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Type of Business:
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Telephone No.
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Supervisor's Name:
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Position and Duties:
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Date of Employment:
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From
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To
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Reason for Leaving:
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Please have documentation of the following at the time of interview: Social Security Number Drivers License Additional Employment History References (up to 3)
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Click on Submit button to send application to hiring manager:
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