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APPLICATION FOR EMPLOYMENT

Evans Unique Support Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender, sexual orientation, gender identity, gender expression, age, status as a protected veteran, or other applicable legally protected characteristics.

By clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time, by the company.

Personal Information: First and Last Name*

Address

Phone Number*

Email Address*

Birth Date

Are You a U.S. Citizen? *

Yes

Employment Desired*

Date you can start

Salary Desired

Have You Worked Here Before? *

Yes

Have You Applied Here Before?*

Yes

Education: High School*

Number of Years Attended *

Graduated?*

Trade School/Other*

Number of Years Attended*

Graduated?*

Area of Study/Degree*

Skills/Qualifications:

Current Employment *

Position*

Salary

Reason for Leaving?

Start Date

May we Contact?*

Yes

Previous Employment:

Position

Salary

Reason for Leaving?

Start Date

End Date

Previous Employment

Position

Salary

Reason for Leaving?

Start Date

End Date

Professional References: Reference 1*

Relationship*

Years Acquainted*

Phone*

Email Address *

Professional Reference 2*

Relationship*

Years Acquainted*

Phone *

Email Address *

Personal Reference*

Relationship**

Years Acquainted**

Phone 2*

Email Address 2*