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, ! ,,, 'City of Ramsey <br />,,! "APPLICATION FOR EMPLOYMENT <br /> (PLEASE PRINT PLAINLY) <br /> <br />[ERSONAL Date: L7/ L// ~3 <br /> <br />~ow ,any y~r, have you "v~ at thb addr~?. ¢ ~ ~elePho"e' No. (C~) 7~/ <br /> How long did you ~ve there? <br /> <br />i~revious address No. Stre~et <br /> <br />Job(s) appli~ for ~./%0~'ci~ ec.e <br /> <br />553'0% <br /> <br />L . 2. i ]~te of pay expected $ :' :-:.Der, ' ........ <br /> ov did yo~ ~,. o~ ,~, o~.~? ~a~;~ ~ &~-~¢~t~..u~'~ ~ : - .~ .... ,: ~ ..... <br /> <br />o you want to work ~ Full-Time or ~ Part-time. S~i~ days and hours if pa~-t~e ....... . <br /> List any friends or relatlv~ working ~or ~ ' ~a~ ] ~I~,5~ ~ ~'~ ~e_. ~'~, .' ' <br /> <br /> If hlr~, on what date will you ~ available to start work? <br />re there any other experience, skills, or qualifi~tions which you feel would ~ ially fit you for work wit the ~mpany? <br /> <br />i <br /> <br /> If hired, do you have a reliable means or transportation to get to Work' ', k?°-~-~ It C~V,,, ~L~ t?ade b <br /> Do you have any physical handicaps which would prevent you from performingtspeci~c kinds of work? /~'cg~/t~--- If yes, <br />Idescribethe defect(s) and explain the work <br /> limitations. <br /> <br />IHaveyou had a serious illness in the past 5 years? ~' No <br /> <br />[] Yes (describe) <br /> <br />IHave you ever received compensation for injuries? /j~ No <br /> <br />[] Yes (explain) <br /> <br />iHave. you ever been convicted, of a crime, excluding misdemeanors and summary offenses? /1~ No 'D Yes <br /> <br /> <br />