Name: (Last Name, First Name, Middle Name - Maiden Name)
Email:
Present Address:
(Eg: 123 Abc St. Anytown, USA, 12345)
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How Long at Address: (in Years)
Telephone Number:
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Social Security Number:
Enter Age: If under 18
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Position:
Desired Salary:
Can you Work Nights?
When can you start?
(Format: YYYY-MM-DD)
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Do you have a preference when you can work?
Days / Hours Available for Work:
| Mon: |
Tue: |
| Wed: |
Thu: |
| Fri: |
Sat: |
| Sun: |
Total: |
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| Type of School: |
Name of School: |
Location:
(Complete Mailing Address) |
Years Attended:
(Example: 1992-1996) |
Major & Degree: |
| High School:
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| College:
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| Bus. / Trade School:
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| Professional School:
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HAVE YOU EVER BEEN CONVICTED OF A CRIME?
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was / were committed, sentence(s), imposed, and type(s) of rehabiliation:
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DO YOU HAVE A DRIVER's LICENSE?:
Driver's License Number: State of issue:
Expiration Date: (Format: YYYY-MM-DD)
License Certifications: Operator:
Commercial (CDL):
Chauffeur:
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What is your means of transportation to work?
How many violations have you had in the past three years?
How many accidents have you had in the past three years?
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Please list computer programs you are proficient in.
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Please list two references other then relatives or previous employers.
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Reference #1:
Name:
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Reference #2:
Name:
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Position:
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Position:
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Company:
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Company:
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Address:
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Address:
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Telephone Number:
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Telephone Number:
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An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
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HAVE YOU EVER BEEN IN THE ARMED FORCES?
ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?
Specialty:
Date Entered: (Format: YYYY-MM-DD)
Discharge Date: (Format: YYYY-MM-DD)
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| Work Experience Please list your work experience for the past five years beginning with you most recent job held. If you were self-employedm give the firm name. |
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Name of previous employer #1:
Address:
Telephone Number:
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Reason for Leaving (be specific)
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List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
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Name of previous employer #2:
Address:
Telephone Number:
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Reason for Leaving (be specific)
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List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
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Name of previous employer #2:
Address:
Telephone Number:
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Reason for Leaving (be specific)
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List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
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Name of previous employer #4:
Address:
Telephone Number:
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Reason for Leaving (be specific)
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List jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
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May we contact your present employer?
Did you complete this application yourself?
If not, who did?
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How would you rate yourself at speaking in front of a group of people?
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What are your hobbies?
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Do you utilize any form of alternative health care? If so, what are they?
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List (3) recreational activities you enjoy.
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How do you feel about Organic Food?
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What is your definition of Alternative Health Care?
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Are you willing to have extensive training in alternative health care and nutrition?
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How do you feel about nutritional supplements?
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Do you like sales?
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Can you author and execute your own marketing plan?
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Do you belong to any associations?
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Have you been a member of any leads groups?
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Considering this type of sales position, whom would you market to?
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What are examples of an unhealthy life style?
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Are you a self starter?
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Do you like to be or need to be micro-managed?
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Are you motivated by money or by helping others?
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