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Code Home Phone Number: ( Referred by: ) Employment Desired: Position desired: Have you ever been employed by Firebirds before? If yes, Where? yes no where: Do you have any relatives working with us? yes no If yes where: Availability: (Please fill in times available to work) Day Mon. Tues. Wed. Thurs. Fri. Sat. Sun. Date you can Start: How many hours per week do you want to work? AM PM Are you currently employed? If yes, Where? yes no Have you ever been convicted of a felon.

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