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Employment Application

Step 1 of 5 - General Information

20%

Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Are you 18 or older?*
- Yes
- No
Are you prevented from lawfully becoming employed in this country because of VISA or IMMIGRATION status?*
- Yes
- No
Position Applying For*
Please choose one:*
- Full Time
- Part Time
Hourly Rate / Salary Desired:*
How were you referred to us?*
Have you ever worked for this company before?*
- Yes
- No
Dates (to and from):*
What was your position?*
What was your rate of pay at the time you left?*
What was your reason for leaving?*
Date Available to Start:*
Do you have a valid Driver's License?*
- Yes
- No
Do you have a valid Commercial Driver's License (CDL)?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
Please explain:*
Please list certifications, special skills and qualifications:*

Highest grade level completed:*
Last school attended:*
Date graduated:*

Start with your last or current position, including any military experience and work back.
Employer:*
Supervisor Name:*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
What was your position?*
What was your ending salary / hourly rate?*
Dates (to and from):*
Reason for leaving:*
Employer:*
Supervisor Name:*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
What was your position?*
What was your ending salary / hourly rate?*
Dates (to and from):*
Reason for leaving:*
Employer:*
Supervisor Name:*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
What was your position?*
What was your ending salary / hourly rate?*
Dates (to and from):*
Reason for leaving:*

Please list references that are not related to you that have known you for at least one year.
Name:*
Phone:*
Name:*
Phone:*
Name:*
Phone:*

By submitting your application below, you certify that your answers are true and complete to the best of your knowledge. You authorize Tytek, Inc. to make such investigations and inquire of your personal, employment, educational, financial, and other related matters as may be necessary for an employment decision. You hereby release employers, schools, or individuals from all liability when responding to inquiries in connection with your application. In the event that you are employed, you understand that false and misleading information given in your application or interview(s) may result in discharge.
Date*
MM slash DD slash YYYY

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