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| Name: |
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| Home Address: |
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| Phone: |
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| School Address: |
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| Phone: |
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| Proposed Work Dates |
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| Earliest date you could arrive for work: |
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| Latest Date you could work:
(Note: If hired, you commit to work the full season listed here) |
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| Position |
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| Position you are applying for: |
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| Reason for applying for work at Eagle's Store: |
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| Education |
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| Indicate last year of school completed: |
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| Are you in school now? |
Yes No |
| Name & Address of School: |
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