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BOOSTER JUICE EMPLOYMENT APPLICATION FORM DATE Position Applied For NAME CONTACT INFORMATION Last First Middle Int. Street Address City Province/State AB Postal/Zip Telephone Email If yes location. Have you ever worked for Booster Juice How did you hear about this location When can you start Desired Wage Are you looking for full time employment Yes AVAILABILITY Hours Available From To Mon Tue EDUCATION School Grade/Level Completed Other Courses Seminars etc. Wed Thurs Fri Sat Sun EMPLOYMENT HISTORY Start with most recent employer 1 Employer Company Name Address Phone Supervisor Can we contact Date Started No Date Ended Responsibilities Reason for Leaving In addition to your work history are there are other skills qualifications or experience we should consider ACTIVITIES Hobbies Sports etc. QUESTIONS Please answer the following questions in the space provided below each question 1. What is one thing you are especially proud of 2. Have you ever been convicted of a criminal offense for which a pardon/record suspension has not been granted If you have never been convicted answer is no if you have been convicted and received a pardon answer is no if you have been convicted and don t have a pardon the answer is yes I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. Street Address City Province/State AB Postal/Zip Telephone Email If yes location* Have you ever worked for Booster Juice How did you hear about this location When can you start Desired Wage Are you looking for full time employment Yes AVAILABILITY Hours Available From To Mon Tue EDUCATION School Grade/Level Completed Other Courses Seminars etc* Wed Thurs Fri Sat Sun EMPLOYMENT HISTORY Start with most recent employer 1 Employer Company Name Address Phone Supervisor Can we contact Date Started No Date Ended Responsibilities Reason for Leaving In addition to your work history are there are other skills qualifications or experience we should consider ACTIVITIES Hobbies Sports etc* QUESTIONS Please answer the following questions in the space provided below each question 1. What is one thing you are especially proud of 2. Have you ever been convicted of a criminal offense for which a pardon/record suspension has not been granted If you have never been convicted answer is no if you have been convicted and received a pardon answer is no if you have been convicted and don t have a pardon the answer is yes I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. .

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