Please complete the information to the best of your ability
Demographics
First Name
Last Name
Preferred Name
Cell Phone
Address 1
Address 2
City
Resume
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What days of the week are you available to work? Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Are you able to start immediately? Yes No
This is an employment application. Prior to you being hired we will ask you to complete a background check. This is important disclosure information.
What's your favorite color Blue Red
What is your Gender? Male Female I do not wish to self-identify
What is your race/ethnicity? Please select the option that describes the race/ethnicity category with which you primarily identify. Hispanic or Latino White Black or African American Native Hawaiian or Other Pacific Islander Asian American Indian or Alaska Native Two or More Races I do not wish to self-identify
Yes - I Identify as one or more of the classifications of a Protected Veteran
No - I do not identify as a Protected Veteran
I do not wish to answer
Do you identify as a person with a disability? A disability is a condition that substantially limits one or more of your "major life activities." If you have or have ever had such a condition, you are a person with a disability. Yes - I have a disability or have had one in the past No - I do not have a disability and have not had one in the past I do not wish to answer
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