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SENT ADDRESS: STREET CITY STREET STATE CITY ZIP PERMANENT ADDRESS: STATE ZIP ARE YOU 18 YEARS OR OLDER? YES NO IF UNDER 18 ARE YOU AT LEAST 17 YEARS OF AGE? YES NO PHONE NUMBER: ARE YOU PREVENTED FROM LAWFULLY BECOMING EMPLOYED IN THIS COUNTRY BECAUSE OF VISA OR IMMIGRATION STATUS? YES NO EMPLOYMENT DESIRED: POSITION: DATE YOU CAN START: SALARY DESIRED: ARE YOU EMPLOYED NOW? IF SO MAY WE INQUIRE OF YOUR PRESENT EMPLOYER? EVER APPLIED TO THIS COMPANY BEFORE? WHERE? WHEN?.

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