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Employment Application
Applicant Information
Position you are applying for
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Parts Cleaner
Office Support
Tear Down Specialist
First Name
Last Name
Middle Name
Street Address
City
State
Zip
Phone
Email
Date Available
Desired Salary
Are you a citizen of the United States?
Yes
No
Are you authorized to work in the U.S.?
Yes
No
Have you ever worked for SouthCentral Outboards?
Yes
No
When did you work for us?
Have you ever been convicted of a felony?
Yes
No
Please explain your felony conviction
Education
High School
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From
To
Did You Graduate?
Yes
No
Diploma
College
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Did You Graduate
Yes
No
Diploma
Other
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From
To
Did you graduate?
Yes
No
Degree
References
Please provide 3 professional references.
Full Name
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Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Full Name
Relationship
Company
Phone
Address
Previous Employment
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Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
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To
Reason For Leaving
May we contact your previous supervisor for a reference?
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No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason For Leaving
May contact your previous supervisor for a reference?
Yes
No
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From
To
Reason For Leaving
May we contact your previous supervisor for a reference?
Yes
No
Military Service
Branch
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To
Rank at Discharge
Type of Discharge
If other than honorable, explain
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
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