Application | Lee Cinco

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Job Application

Please complete the form to apply for a position with us.

Personal Information

First Name

Last Name

Date of Birth * required

Email Address

Phone

Social Security Number

Street Address

Postal / Zip code

Street Address Line 2

City

Region/State/Province

Country

Referred by:

Availability * Required

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Available Start Date * required

Desired Position

Are you an independent contractor? (1099) *

Yes

No

Desired Salary

Have you ever been convicted of a misdemeanor charge? *

Yes

No

Have you ever been convicted of a felonly? *

Yes

No

Can we run a background check using the information provided above? *

Yes

No

Education

1. School Name

Location

Years

Degree Received

2. School Name

Location

Years

Degree Received

3. School Name

Location

Years

Degree Received

Work History

1. Employer Name

Location

Phone Number

Pay

Start Date * required

End Date * required

Position

Reason for leaving?

2. Employer Name

Location

Phone Number

Pay

Start Date * required

End Date * required

Position

Reason for leaving?

3. Employer Name

Location

Phone Number

Pay

Start Date * required

End Date * required

Position

Reason for leaving?

References

1. Reference Name

Relationship

Years Known

Phone Number

2. Reference Name

Relationship

Years Known

Phone Number

3. Reference Name

Relationship

Years Known

Phone Number

Upload Resume

Upload File

Upload supported file (Max 15MB)

Upload Certificate (1)

Upload File

Upload supported file (Max 15MB)

Upload Certificate (2)

Upload File

Upload supported file (Max 15MB)

By checking this box I am confirming that all of the information above is correct and is accurately filled out to the best of my knowledge.

By checking this box, I am authorizing an investigation of all statements contained in this application for employment as it may be necessary in arriving at an employment decision.

By checking this box, in the event of employment, I understand that false or misleading information given in my application or interview(s) may result in termination.

Thanks for submitting!

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