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CAS America
Employment Application Form

Pre-Employment Questionnaire
An Equal Oppurtunity Employer

Personal Information
*Full Name
*SS#
*Telephone
*Address
*City
*State
*Zip
*Are you 18 years or older?	Yes No

Employment Desired
*Position Applying For
*Date you can begin
*Salary Desired
*Are You Currently Employed	Yes No
*If yes, may we contact empoloyer	Yes No
*Employment Sought	Regular Time Part Time
*Have you ever applied to this company before?	Yes No
*Can you, at the time of employment, submit verification of your legal right to work in the United States?	Yes No
*How did you hear about this position?

Education Acheived
High School
Years attended High School
College
Years attended College
Major
Trade, Business School
Years attended Trade, Business School

Please Answer
Why are you interested in becoming an employee with CAS America
What are your career goals

Employment History - Most Recent Employer
Company Name
Supervisor
Last Position
Telephone
Address
City
State
Zip
Dates of Employment
Responsibilities
Reason for leaving
Weekly Starting Salary
Weekly Final Salary
Do we have permission to contact the above company?	Yes No

Employment History - 2nd Most Recent Employer
Company Name
Supervisor
Last Position
Telephone
Address
City
State
Zip
Dates of Employment
Responsibilities
Reason for leaving
Weekly Starting Salary
Weekly Final Salary
Do we have permission to contact the above company?	Yes No

Employment History - 3rd Most Recent Employer
Company Name
Supervisor
Last Position
Telephone
Address
City
State
Zip
Dates of Employment
Responsibilities
Reason for leaving
Weekly Starting Salary
Weekly Final Salary
Do we have permission to contact the above company?	Yes No

Employment History - 4th Most Recent Employer
Company Name
Supervisor
Last Position
Telephone
Address
City
State
Zip
Dates of Employment
Responsibilities
Reason for leaving
Weekly Starting Salary
Weekly Final Salary
Do we have permission to contact the above company?	Yes No

* indicates Required

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