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APPLICATION FOR EMPLOYMENT - Wake Up Call

APPLICATION FOR EMPLOYMENT Weareanequalopportunityemployer,dedicate dtoapolicyofnon-discriminationinemployme ntbasedonage,sex,color,race,creed, national origin, religious persuasion, marital status, or disability that does not prohibit performance of essential job functions. Iunderstandthatanyfalsificationorwillful omissionoffactmadeinthisapplicationorinc onnectionwithanybackgroundinvestigationm ay be sufficient grounds for rejection of this APPLICATION , or if discovered after an offer of EMPLOYMENT , for immediate dismissal. I. Personal Information Date: _____ _____ Name:LastFirstMiddle _____ Present AddressEmail Address _____ CityStateZipTelephone 1. Is there any information we would need about your name or use of another name for us to be able to check your work record? Please specify: _____ 2. Do you have any relatives who are or have ever been employed by Wake Up? _____ 3. How were you referred to Wake Up? Please give name of person, agency or newspaper.

APPLICATION FOR EMPLOYMENT We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment based on age, sex, color, race, creed,

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