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Buckeye Outdoors
An Equal Opportunity Employer
Application for Employment
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150 Arrowhead Blvd.
Hebron, Ohio 43025
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1. Position applied for
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(one per application)
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2. Social Security No.
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3. Full legal name
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5. Home Phone
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( )
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Last
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First
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Middle
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6. Address
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6. Business Phone
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( )
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7. E-mail Address
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City
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State
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Zip
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8. EDUCATION
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a. Check highest
grade completed
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1 2 3
4 5
6 7
8 9
10 11
12
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b. If you did not complete high
school, do you have a high school equivalency diploma?
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Yes
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No
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c. Check number of years of post
high school education
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1
2 3
4 5
6 7
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Name and Location of Institution
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Hrs
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Degree Received
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Major or Specialty
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Minor
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Dates Attended
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1.
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2.
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3.
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d. If you expect to complete an
educational program in the near future, please indicate what
type of degree or program and expected
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completion date:
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9. EXPERIENCE — Starting
with the most recent, describe ALL paid, military and
applicable voluntary experience. Highlight your knowledge,
skills and abilities which best demonstrate your
qualifications for this position.
You may list significantly
different jobs within the same organization as separate
items. May we contact your present supervisor?
Yes No
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a. Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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b. Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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c. Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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d. Use this space for any additional
information you think would help us evaluate your application,
including training, seminars, workshops,
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and special achievements or
specialized skills:
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e. Automated word processing (specify
equipment)
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Typing speed
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words per minute.
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Shorthand speed
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words per minute
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f. License (to include driver’s),
certificate or other authorization to practice a trade or
profession.
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Type
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License Number
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Granted by (licensing board)
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10. REFERENCES
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List names, addresses and
relationships of three persons not related to you who know
your qualifications:
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Name
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Address
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Phone
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Relationship
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11.
MISCELLANEOUS
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a. Check which shift you will accept:
Day Evening
Night Rotating
Weekends Specify shift hours
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b. Check which job status you will
accept: Full-time Part-time (specify)
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c. Have you ever been convicted* for
any violation(s) of law, including moving traffic violations.
Yes No If YES, please provide the following:
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Description of offense:
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Statute or ordinance (if known ):
Date of Charge: ; Date of Conviction
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County, City, State of Conviction:
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(For additional convictions use plain
paper. Include all information listed above.)
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*Convictions include juvenile
adjudications for Capital Murder, First and Second Degree
Murder, Lynching, or Aggravated Malicious Wounding, if you were
age
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fourteen (14) to eighteen (18) when
charged.
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12. When will you be available to
start work? (No date is necessary if you are available as soon
as you give two (2) weeks notice.)
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Month
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Day
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Year
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13. CERTIFICATION--Each
Application Requires Current Date and Original Signature
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I hereby certify that all entries
on both sides and attachments are true and complete, and I
agree and understand that any falsification of information
herein, regardless of time of discovery, may cause
forfeiture on my part of any employment in the service of
Buckeye Outdoors. I understand that all information on this
application is subject to verification and I consent to
criminal history background checks. I also consent that you
may contact references, former employers and educational
institutions listed regarding this application. I further
authorize Buckeye Outdoors to rely upon and use, as it sees
fit, any information received from such contacts.
Information contained on this application may be
disseminated to other agencies, nongovernmental
organizations or systems on a need-to-know basis for good
cause shown as determined by the agency head or designee.
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Date
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Applicant Signature
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Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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Job Title
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Duties:
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Employer
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Address
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Phone
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Type of business
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Immediate supervisor
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Title
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Number and titles of employees you
supervised
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Salary (start)
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(finish)
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Equipment used
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Dates (mo/yr)
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to (mo/yr)
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Reason for leaving
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Full-time
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Part-time
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Hours/week
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Your name if different from present
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