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Education Background





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Record of Employment (Three Most Recent Employers, Most Recent First)

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Please Read Completely and Carefully

Physical Information:

Some of our jobs may have special physical requirements. If you are applying for such a position, our personnel staff will ask you about your ability to perform certain job functions and may ask you to perform such functions. After a conditional job offer has been made, you may be required to complete a medical history questionnaire to provide information that we believe to be relevant to your ability to perform the job being offered.

Equal Opportunity Employer:

This firm is an equal opportunity employer and does not discriminate on the basis of sex, age, race and color, religion, marital status, national origin, disability or veteran status.

Interviews:

Interviews and hiring are on a competitive basis, using job-related factors after a written application has been received. Because an application has been received, it does not necessarily mean an interview will be granted.

Termination – Permission to Acquire Information:

If employed, I agree to conform to this firm’s rules and regulation as set forth now or hereafter in any of their operations and policy manuals and other communications. I understand non- conformity will be grounds for dismissal.

Statement:

I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for dismissal. Permission, unless indicated to the contrary, is granted to confirm by personal inquiry or such other necessary means the information as set forth herein. Any information so obtained shall remain confidential.

I understand that the Immigration Reform and Contro
l Act may require me to prove the legality of me residency or citizenship and that failure to do so may cause the termination of my employment with or without notice to me. I further understand and agree that, at any time, my employment and compensation can be terminated, with or without cause, and without notice, at the option of my employer.



Affirmative Action

This information is optional. If provided, it will be used in our affirmative action program. This information may not be used to discriminate against you.

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