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We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis including age, sex, color, race, creed, national origin, religious persuasion, marital status, political belief, or disability that does not prohibit performance of essential job function.

Personal Information

Name(Required)

First Middle Last

Present Address(Required)

Street Address Address Line 2 City State ZIP Code

Permanent Address

Street Address Address Line 2 City State ZIP Code

If different from above.

Phone(Required)

Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver’s license, birth certificate, Green Card etc) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.

Position Applied For(Required)

Is there any information we would need to know about your name or use of another name for us to be able to check your work record? Please specify:

Do you have any relatives who are presently (or have formerly been) employed by Log Cabin?(Required)

Yes

How were you referred to Log Cabin?(Required)

Have you ever been convicted of a felony?(Required)

Yes

Educational History

High School

College

Technical Training

Other

Employment Record

Please include all employment for the past five years

Company Name(Required)

Position Held(Required)

Address(Required)

Date Employeed(Required)

Manager / Supervisor(Required)

Phone(Required)

Reason for Leaving(Required)

Company Name

Position Held

Address

Date Employeed

Manager / Supervisor

Phone

Reason for Leaving

Company Name

Position Held

Address

Date Employeed

Manager / Supervisor

Phone

Reason for Leaving

Company Name

Position Held

Address

Date Employeed

Manager / Supervisor

Phone

Reason for Leaving

Company Name

Position Held

Address

Date Employeed

Manager / Supervisor

Phone

Reason for Leaving

School Schedule

Availability(Required)

Phone

This field is for validation purposes and should be left unchanged.