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* 1. Name of your Industry

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* 2. Location (street, city, zip code)

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* 3. Contact Person: (Name, Job Title, Phone, Email)

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* 4. # of Employees

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* 5. Please specify when shift changes occur.
(Ex. 1st Shift: 7a-3p, 2nd Shift: 3p-11p, 3rd Shift: 11p-7a)

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