June 14, 2022 Centerville, OH June 14, 2022/ Alex Trujillo The Whit’s you are applying to is located at 199 N. Main St. Centerville, OH Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How many years have you lived at your current address? Phone Number * Are you at least 16 years of age? (Must be 16 years old at the time of application to be considered) * Yes No Do you have transportation to work? * Yes No Are you legally authorized to work in the United States? * Yes No Do you have prior work experience? Please summarize. (Including dates of employment and reason for leaving). What is the earliest date you can start? * MM DD YYYY Emergency Contact Name * Emergency Contact Phone Number: * (###) ### #### Relationship to Emergency Contact (parent, spouse, etc): Would you prefer to work * Full Time Part Time Total Number of Hours per week you are available to work Are you in school? Yes No If yes, what school do you attend? Monday Availability * Not Available Morning Evening Any Tuesday Availability * Not Available Morning Evening Any Wednesday Availability * Not Available Morning Evening Any Thursday Availability Not Available Morning Evening Any Friday Availability Not Available Morning Evening Any Saturday Availability Not Available Morning Evening Any Sunday Availability Not Available Morning Evening Any Your Message * I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment. Thank you!
