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EMPLOYMENT INFORMATION FORM

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  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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