Last Name:
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First Name:
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Middle Intial:
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Home Phone:
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Street Address:
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Apartment Number:
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City:
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State:
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Zip Code:
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Do you have relatives working for this company?
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If yes, who?:
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Have you ever applied for employment with Coast West Plumbing, Inc.
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If yes, when?:
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Do you have the right to work in the United States?
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If hired, proof of a lawful right to work in the United States will be required.
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Do you have any responsibilities, commitments or activities that would prevent you from:
Working Overtime?
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Traveling?
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Working specific work schedules?
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If hired, can you furnish proof of age?
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When can you report?:
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How were you referred?:
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Position desired?:
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Salary desired?:
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If hired, will you assume responsibility for arranging transportation to and from work?
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EDUCATION
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High School:
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Location:
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Graduated:
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Community College:
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Years Completed:
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Units:
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From (Mo./Yr.):
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To (Mo./Yr.):
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Degree:
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Major:
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GPA:
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College
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Years Completed
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Units:
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From (Mo./Yr.): To (Mo./Yr.):
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Degree:
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Major:
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GPA:
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College
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Years Completed
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Units:
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From (Mo./Yr.): To (Mo./Yr.):
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Degree:
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Major:
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GPA:
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Business or Trade School
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Years Completed
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Units:
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From (Mo./Yr.): To (Mo./Yr.):
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Degree:
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Major:
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GPA:
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Honors and Awards
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Professional Designations
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College Expenses Earned
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MILITARY
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Have you ever served in the United States Armed Forces?
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If yes, Branch:
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If yes, give dates:
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to
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Final Rank:
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ADDITIONAL INFORMATION
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Have you been convicted of a felony within the last seven years?
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If yes, explain in comment area below, in detail as to time, nature, and number of convictions. (All information provided will be taken into consideration. Conviction of a crime is not necessarily a disqualification.)
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Have you used any name other than the name you are currently using while attending school or with a previous employer?
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If yes, list name(s) you've used:
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EMPLOYMENT HISTORY
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List all employment and periods of unemployment.
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1. Company
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Company name:
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May we contact?
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Job Title:
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Address:
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City:
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State:
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Zip:
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Supervisor:
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Phone:
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Approx number of days absent each year other than vacation:
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Reason for leaving:
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Full Time:
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Part Time:
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Dates of Employment (Mo/Yr) From To
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Duties Summary:
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2. Company
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Company name:
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May we contact?
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Job Title:
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Address:
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City:
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State:
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Zip:
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Supervisor:
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Phone:
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Approx number of days absent each year other than vacation:
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Reason for leaving:
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Full Time:
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Part Time:
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Dates of Employment (Mo/Yr) From To
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Duties Summary:
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3. Company
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Company name:
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May we contact?
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Job Title:
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Address:
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City:
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State:
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Zip:
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Supervisor:
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Phone:
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Approx number of days absent each year other than vacation:
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Reason for leaving:
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Full Time:
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Part Time:
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Dates of Employment (Mo/Yr) From To
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Duties Summary:
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