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First Name
Last Name
Email
Home Phone
Cell Phone
Address
City
State
Zip Code
How far do you live from LaGrange, GA?
20 miles or less
Between 20 and 40 miles
40 or more miles
What is the highest level of education you have completed?
GED
High School Diploma
Some college
Associates Degree
Bachelor's Degree
Master's Degree
(1) Current Employer
(1) Current Position and Short Description of Your Responsibilities
(1) Current Salary
(1) Why are you looking for something new?
(2) Previous Employer
(2) Previous Position and Short Description of Your Responsibilities
(2) Previous Salary
(2) Reason for Leaving
(3) Previous Employer
(3) Previous Position and Short Description of Your Responsibilities
(3) Previous Salary
(3) Reason for Leaving
I am legally eligible for employment in the U.S.
U.S. Citizen
Alien Authorized to Work in the U.S.
Other
Have you ever been convicted of a felony?
Yes
No
If Yes please explain
Are you fluent in any foreign language? If Yes, please specify the language:
Please list any skills or software applications that you have experience with, that are directly related to the position you are applying for:
Have you ever worked for or applied for a position with Mountville Mills, Inc; Mountville Rubber Company; Logo Mats, LLC; The Andersen Company or Bungalow Flooring?
YES
NO
If Yes please list the position and dates of employment or month and year you applied for the position:
I certify that the information provided on this application is true and correct to the best of my knowledge.
Your initials certify your agreement with the above information.
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