Employment Information Form

               EMPLOYMENT INFORMATION FORM

Date:_______________

Employer_________________________    Telephone:_________________

Address__________________________

City_____________________________

State____________________________

Zip______________________________

Nature of business___________________________________________

Position to be filled___________________________________________

Employee qualifications_______________________________________

Number of employees needed__________________________________

Wages or salary $________________ per __________________________

Employment is _____temporary ______permanent

Hours ________ to _______

Days ___________ to __________

Benefits_______________________________________________________

We are an equal opportunity employer.

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