* 1. First Name, Middle Initial & Last Name

* 2. Email Address (*extremely important*) & Phone Number:

* 3. Where do you currently reside (street, city, state, zip)?

* 4. Education (please list high school with graduation year, as well as any post-secondary education with dates and degree/certification):

* 5. Employment History (please list your three most recent jobs starting with the most recent, with company name, company city & state, job title, dates of employment, supervisor name, phone number and reason for leaving)

* 6. References (please list THREE three PERSONAL, non-family, references complete with first & last name, phone number, email address, and how you know them. An EMAIL ADDRESS is IMPORTANT, please provide when possible)

* 7. I... (check all that apply)

* 8. I can comfortably, easily, independently lift...

* 9. I'm generally available to work the following days and times until at least mid-May (please list your entire availability, including hours beyond what hours you're interested in):

* 10. What else can you tell me about you (i.e. stuff beyond your experience and credentials; hobbies, interests, family, fun facts... really show me who you are and make me want to meet you!)

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