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| * FIRST NAME: |
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* LAST NAME: |
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| * ADDRESS: |
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* CITY: |
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| * STATE: |
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* ZIP: |
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| * EMAIL: |
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* HOME PHONE: |
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| WORK PHONE: |
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CELL PHONE: |
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| * POSITION APPLYING FOR: |
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* CURRENT POSITION HELD: |
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Please copy and paste your Cover Letter & Resume or complete the application below:
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| TYPE OF
WORK DESIRED: |
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WHEN CAN
YOU START?: |
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| HOW DID YOU LEARN ABOUT NAC?: |
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| ARE YOU EIGHTEEN YEARS OF AGE OR OLDER?:
Yes
No |
| ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE U.S.?:
Yes
No |
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| MOST RECENT OR PRESENT JOB FIRST |
| PRESENT JOB: |
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| EMPLOYMENT DATES (INCLUDE MILITARY): |
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| FIRM NAME, ADDRESS, AND NAME OF SUPERVISOR: |
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| YOUR JOB TITLE AND DUTIES: |
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| SALARY: |
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| REASON FOR LEAVING: |
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| PAST JOB #2: |
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| EMPLOYMENT DATES (INCLUDE MILITARY): |
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| FIRM NAME, ADDRESS, AND NAME OF SUPERVISOR: |
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| YOUR JOB TITLE AND DUTIES: |
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| SALARY: |
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| REASON FOR LEAVING: |
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| PAST JOB #3: |
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| EMPLOYMENT DATES (INCLUDE MILITARY): |
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| FIRM NAME, ADDRESS, AND NAME OF SUPERVISOR: |
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| YOUR JOB TITLE AND DUTIES: |
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| SALARY: |
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| REASON FOR LEAVING: |
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| PAST JOB #4: |
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| EMPLOYMENT DATES (INCLUDE MILITARY): |
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| FIRM NAME, ADDRESS, AND NAME OF SUPERVISOR: |
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| YOUR JOB TITLE AND DUTIES: |
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| SALARY: |
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| REASON FOR LEAVING: |
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| PAST JOB #5: |
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| EMPLOYMENT DATES (INCLUDE MILITARY): |
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| FIRM NAME, ADDRESS, AND NAME OF SUPERVISOR: |
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| YOUR JOB TITLE AND DUTIES: |
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| SALARY: |
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| REASON FOR LEAVING: |
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| EXPLAIN PERIODS OF UNEMPLOYMENT: |
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Would you consent to a pre-commencement testing, if required, including drug screening, medical testing and/or skill-related testing?
YES
NO
Have you ever been convicted of a criminal offense (felony or serious misdemeanor)?
YES
NO If yes, state nature of the crime(s), when and where convicted, and disposition of the case.
Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however, be considered.)
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| SUMMARIZE SPECIAL SKILLS AND QUALIFICATIONS
ACQUIRED FROM EMPLOYMENT OR OTHER EXPERIENCE. |
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| COMPUTER SOFTWARE: |
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| KEYBOARDING (wpm): |
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| LANGUAGE(S): |
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| OTHER: |
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List professional, trade, business or civic activities and offices held (you may exclude those which indicate race, color, religion, sex or national origin) :
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| 24/7 SHIFT AVAILABILITY - FT/PT: |
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| SALARY REQUIREMENT: |
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Give name, address and telephone number of three references
who aren't related to you and are not previous employers. |
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I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for dismissal. I also authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I hereby release from all liability, all persons, companies, or corporations furnishing such information. In consideration of my employment, I agree to conform to the rules and regulations of National Automobile Club, and my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the Club or myself. |
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