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(Pre-Employment Questionaire) (An Equal Opportunity Employer)

Preapplication form:

Name: Telephone:

Birthdate: Address:

What is the last year of school you have completed?

What postion are you applying for?

Are you applying for (check one) Full-time Part-time

What hours are you available to work?

Monday from to

Tuesday from to

Wednesday from to

Thursday from to

Friday from to

Saturday from to

Sunday from to