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Employment Application COMPANY OR EMPLOYER NAME: Position applying for: EMPLOYEE INFORMATION Name: Last Telephone: First Middle Alternate telephone: Email: Address: If necessary for the job, I am able to: Yes Work overtime Yes Provide a valid Alaska Driver s License If so, fill out the following: Issuing state: Type: Are you able to perform the essential functions of the position with or without accommodations Yes No If necessary for the job are you older than: 14 15 16 18 19 21 (Check one) Endorsement(s): I am legally eligible for employment in the U.S. Yes No I am seeking a permanent position: Yes No Hazardous Material No No Passengers Tankers Tank with Hazardous Materials School Bus Double/Triple trailers Work the following shifts: (check all that apply) I will be able to report to work days after being notified I am hired..
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