employment

Full Name	Full Name
Street Address	Street Address
City	City
State	State
How long have you lived here	How long have you lived here
Telephone	Telephone
If under 18, please list age	If under 18, please list age
Are You legally eligible to work in the United States?	Are You legally eligible to work in the United States?
Position applied for (1)	Position applied for (1)
And salary desired (2) (Be specific)	And salary desired (2)
Days/ hours available to work	No Pref No Pref	ThurThur
	MonMon	FriFri
	TueTue	SatSat
	WedWed	SunSun
How many hours can you work weekly?	How many hours can you work weekly?
Can you work nights?	Can you work nights?
When available for work?	When available for work?
Employment desired	Employment desiredFULL-TIME ONLYPART-TIME ONLYFULL OR PART-TIME
Do you play any sports or dance or any extra curricular activities?	dance
List last 3 years of job experience	years
HAVE YOU EVER BEEN CONVICTED OF A CRIME?	HAVE YOU EVER BEEN CONVICTED OF A CRIME? Yes Yes No No
If yes, explain number of conviction(s), nature of offence(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.	comments