LEBANON VALLEY SPEEDWAY & DRAGWAY

2008 APPLICATION FOR EMPLOYMENT

(OFFICIAL)

 

 

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LAST NAME                                      FIRST NAME                         MIDDLE INITIAL

 

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MAILING ADDRESS (INCLUDE YOUR 911 ADDRESS)

 

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CITY                                                  STATE                        ZIP CODE

 

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AREA CODE & PHONE NUMBER         CELL #                              OTHER NUMBER

 

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DATE OF BIRTH                   AGE                 SEX          SOCIAL SECURITY NUMBER

 

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PERSONAL REFERENCE AND PHONE NUMBER

 

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EMERGENCY CONTACT PERSON                                       PHONE NUMBER

 

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E-MAIL ADDRESS

 

WHEN ARE YOU ABLE TO WORK?  ________ SPEEDWAY

                                                                       ____ SATURDAY NIGHTS

                                                                       ____  MIDWEEK EVENTS

                                                        ________ DRAGWAY

                                                                       ____ WEDNESDAYS

                                                                       ____ SATURDAY

                                                                       ____ SUNDAY  

                                                                       ____ MIDWEEK EVENTS

 

HAVE YOU WORKED WITH US BEFORE?  ____ YES  ____ NO

 

PLEASE COMPLETE APPLICATION AND RETURN TO:

LOUISE I. CLOUSER

P.O. BOX 9

WEST LEBANON, NEW YORK 12195

 

You need to provide me a copy of your Drivers License and Social Security Card.                

PLEASE PRINT CLEARLY!

THANK-YOU