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APPLICATION FORM
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4412 S. 42nd Street, Omaha, NE 68107
OmahaEmenu.com/Mandarin Fusion
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| PERSONAL INFORMATION |
Social Security Number |
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| Last Name |
First Name |
Middle Name |
Age |
Sex |
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| Present Address Street |
City |
State |
Zip |
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| Permanent Address Street |
City |
State |
Zip |
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| Phone Number |
Cell Phone |
Own Home |
Rent |
Board |
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| Date of Birth |
Height |
Weight |
Color
of Hair |
Color
of Eyes |
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| Single |
Married |
Widowed |
Divorced |
Separated |
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| U.S. Citizen |
Green Card |
Working Permit |
Number of Children |
Number of Dependents
Other Than Spouse or Children |
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if Related to Anyone in Our
Employ, State the Name |
How You Found Us |
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| Position |
Date You
Can Start |
Salary
Desired |
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| Your Present or Previous Employer |
May We Inquire of Them? |
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| Ever Applied To This Company Before? |
Where |
When |
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| EDUCATION |
Name and Location of School |
Years
Attended |
Date
Graduated |
Subject Studied |
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| Subject of Special Study or Research Work |
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| Foreign Language You Can Speak Fluently |
Read % |
Write % |
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U. S. Military or
Naval Service |
Rank |
Present Membership in
National Guard or Reserves |
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Activities Other Than Religious
(Civic, Athletic, Fraternal, etc.) |
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| EXCLUDE ORGANIZATIONS THAT THE NAME OR CHARACTER OF WHICH INDECATES THE RACE, CREED, COLOR OR NATIONAL ORIGIN OF ITS MEMBERS |
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