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shall be afforded equal opportunity in all aspects of employment without regard to race, color, religion, political affiliation, national origin, disability, marital status, gender or age. APPLICATION FOR EMPLOYMENT PERSONAL INFORMATION: Name (Last, First, Middle): Date: Present Address (Street, City, State, Zip): Last Name Permanent Address (Street, City, State, Zip): Phone Number: Social Security Number: List Any Relatives In Our Employ: Referred By: EMPLOYMENT DESIRED: Position: Sal.

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