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EMPLOYMENT APPLICATION SUBMITION FORM

NOTE: All logins and i.p. addresses to this website are automatically recorded and any misuse or profanity is a violation of FCC Laws and will be reported

!! PHONE CALLS !!

860-444-0462

PLEASE SUBMIT APPLICATION FIRST

***experience will receive precedence***

Please submit all personal qualifications which you feel makes you the best candidate for the position or positions available.

ALL APPLICANTS SUBJECT TO DRUG TESTING AND BACKGROUND CHECKS

ON LINE APPLICATION:

Name

ADDRESS: INCLUDE (STREET, CITY, STATE AND ZIP)

PHONE NUMBER:

EMAIL ADDRESS:

SOCIAL SECURITY NUMBER:

DATE OF BIRTH:

ADDITIONAL LANGUAGES: WRITE / SPEAK FLUENTLY (IF BI-LINGUAL)

EXPECTED PAY:

PROFESSIONAL LICENSES HELD: (IF ANY)

PROFESSIONAL LICENSES HELD: (IF ANY)

QUALIFICATIONS: MOST RECENT EMPLOYER: Name; Address; Phone Number; Dates of Employment; Job Title; Job Description; Supervisor; Ending Salary; Reason For Leaving

PREVIOUS EMPLOYER #2: (if less than 3 years at most recent)

PREVIOUS EMPLOYER #3: (if less than 3 years combined)

MILITARY SERVICE HISTORY: Branch; Rank; Dates of Service; Job Description; Type of Discharge (explain if other then honorable)

DRIVING RECORD HISTORY EXPLANATION:

REFERENCES: Please provide 3 professional references and 2 personal references, include: Name, Address, Phone Number, Company(if professional reference), Relationship(if personal reference), Number of years aquainted

Please write a sentence or two explaining why you feel, you are the best candidate for the position or positions available:

TIME OF APPLICATION:

DATE OF APPLICATION:

DATE AVAILABLE:

By pressing [send], I (the applicant) certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Thank you for your interest in working for our company

Jeffrey L. Decker is an Equal Opportunity Employer

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