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* 1. Date

Date

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* 2. Full Name

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* 3. Street Address (include City, State, Zip)

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* 4. Phone Number

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* 5. Email Address

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* 6. Do you have a high school diploma or GED?

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* 7. Are you 18 years of age or older?

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* 8. Position Desired

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* 9. What are your salary requirements?

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* 10. What is your desired schedule

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* 11. There are opportunities for overtime and required Saturdays occasionally. Are you willing to work those days?

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* 12. If the position you are applying for requires the operation of a motor vehicle, do you have a valid license?

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* 13. Are you a US citizen, or do you have the legal right to employment?

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* 14. Have you been convicted of a felony in the last 7 years? Please note that "conviction" includes plea, verdict, or finding of guilt, regardless of whether you were sentenced by a court.

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* 15. Have you ever been convicted of a misdemeanor within the last 7 years? Please note that "conviction" includes plea, verdict, or finding of guilt, regardless of whether you were sentenced by a court.

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* 16. Are you currently awaiting trial for a felony? A conviction will not necessarily disqualify you from the position for which you are applying.

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 25% of survey complete.

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