WPC u= Ņ i 4 p˼`X!HiE~FE"|@Y kx<7dNK"O%&yⓌجGN(޲ č+NWIjﵢ;C=}Z'*nwXSGwr$J/lhC,† 7&ڲ\6rab43bye) ȏ$g(pY;&']..RjWiC%/֠s }[hgpͽYkM3--i ¥d7qq2cBJh!ڜ6WdQ^zHͧK{iw)Pۗ0dG:KL]8 @UC{'hgDi e'g-vwV3{4k!.mߙH┟ЯZ#UN % 0: 0UC 0 0u 04 0 0 0M 0 0 00 0 0 0g 0 0 0J 0 0n 0 0 0y 0# 0 0e 0 0 0 0NUg>^ +w74;O^ m`EwNy@{. BHP Color LaserJet 35500(@ Z6Times New Roman RegularX($USUS.,*+ (_2623  ..*D+D (_25   ," <DL,23  ..," <DL,   *5+5 (_24  ) <DL)23  ..) <DL)  *2+2 (_23 ` &<<DL&23  ..&<<DL& ` */+/ (_22  #DL#23  ..#DL#  *,+, (_21   DL 23  .. DL  *)+) (_20 h DDL23  ..DDL h *&+& (_19  L23  ..L  *#+# (_18   L23  .. 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L       Returnto:HumanResourceOffice,1780WestlandRd.,Cheyenne,WY82001 8 #XXX!X#!XXXX!_X!X1.#!XX!_#!_X!X  OfficialJobTitleasStatedonAnnouncement_____________________________________________________________    #!XX!_ #!_X!X2.#!XX!_#!_X!X  LastName#!XX!_#!_X!X 4 #!XX!_t#!_X!X #!XX!_#!_X!X FirstName#!XX!_#!_X!X  #!XX!_h#!_X!X  #!XX!_#!_X!X D MiddleInitial#!XX!_ #!_X!X  #!XX!_` #!_X!XSocialSecurityNumber#_!_##XX_ #_XX!__ \    #!XX!_) #!_X!X____________________________________________________________________________________________________  V  #!XX!_ #!_X!X3.#!XX!_f #!_X!X  MailingAddress#!XX!_ #!_X!X #!XX!_ #!_X!X City#!XX!_U #!_X!X < #!XX!_ #!_X!X  #!XX!_ #!_X!X  #!XX!_C #!_X!XState#!XX!_ #!_X!X D 0  #!XX!_ #!_X!XZip#!XX!_2#!_X!XԀE#!XX!_w#!_X!Xmailaddress  a&a& #_!_H ##XX_#!XXXX!_X!X0  ___________________________________________________________________________________________________ a&a& #!XX!_#!_X!X4.#!XX!_O#!_X!X  HomePhone##!XX!_#!_X!X 4 5.DayorMessagePhone##!XX!_#!_X!X  6.Driver#!XX!_T#!_X!XsLicense##!XX!_#!_X!X  State#!XX!_#!_X!X  Type d  #!XX!_P#!_X!X  ____________________________________________________________________________________________________ &^ #!XX!_#!_X!X7.#!XX!_#!_X!X  Circletypeofappointmentyouwouldaccept:Full#!XX!_#!_X!XtimePart#!XX!_I#!_X!XTimeEveningsGravesWeekendsRelief   #!XX!_#!_X!X  ____________________________________________________________________________________________________  #!XX!_'#!_X!X8.#!XX!_#!_X!X  WhoreferredyoutoMagicCityEnterprisesforemployment?_______________________________________________ l #!XX!_2#!_X!X9.#!XX!_#!_X!X  DoyouhaveanyrelativesorroommatesemployedmyMagicCityEnterprises?Yes#!XX!_C#!_X!XNoIf Yes,pleasespecify (   theirnameanddivision#!XX!_#!_X!X._________________________________________________________________________  #!XX!_#!_X!X10.#!XX!_)#!_X!X  Dateavailableforwork:_______________________________________________________________________________ 6n #!XX!_n#!_X!X11.#!XX!_9#!_X!X  IfyouhaveworkedforMCEinthepast,specifydivisionanddatesofemployment:  #!XX!_~#!_X!X  _____________________________________________#_!_`##XX_3#_XX!__________________________________________________ | #!XX!_#!_X!X12.#!XX!_w#!_X!X  Haveyoueverbeenemployedorattendedschoolunderanyothernames?ListNames >v #!XX!_#!_X!X  ____________________________________________________________________________________________________ 8 #!XX!_p#!_X!X13.#!XX!_8#!_X!X  Haveyouhaveanytrafficviolationsinthepast5years?Yes#!XX!_}#!_X!X D No#!XX!_ #!_X!X  If Yes,listtheviolations:   #!XX!_[#!_X!X  ____________________________________________________________________________________________________ F~! #!XX!_#!_X!X14.#!XX!_ #!_X!X  Haveyoueverbeenconvictedofafelonyorbeenlegallyincarcerated?YesNo#!XX!_ #!_X!X  If Yes,Onaseparatepieceof#!XX!_!#!_X!X @"   paper,givethedates,detailsandpenaltiesforeachoccurrence.#!XX!_ "#!_X!XAnanswer#!XX!_"#!_X!X yes#!XX!_##!_X!Xdoesnotconstituteanautomatic#!XX!_L##!_X!X #   disqualificationfromemployment._______________________________________________________________________ $ #!XX!_##!_X!X15.#!XX!_$#!_X!X  DoyouhaveaHighSchoolDiplomaorGEDCertificate?Yes#!XX!_$#!_X!X D No#!XX!_i%#!_X!X  HighSchool/Location: H& #!XX!_%#!_X!X  ____________________________________________________________________________________________________  ' #!XX!_2&#!_X!X16.#!XX!_&#!_X!X  CollegeorVocationalSchoolandLocation#!XX!_>'#!_X!X  Dates#!XX!_'#!_X!X  #!XX!_(#!_X!X D Hours#!XX!_V(#!_X!X  #!XX!_(#!_X!X  Major#!XX!_(#!_X!XԀ#!XX!_J)#!_X!XDegreeEarned  (   #!XX!_)#!_X!X____________________________________________________________________________________________________#!XX!_*#!_X!X V! )   ____________________________________________________________________________________________________ "P!* #!XX!_*#!_X!X  ____________________________________________________________________________________________________#!XX!_+#!_X!X ""+   ____________________________________________________________________________________________________ #", #!XX!_:,#!_X!X17.#!XX!_-#!_X!X  ListotherJOB#!XX!_[-#!_X!XRELATEDspecialqualificationsandskills,suchasFirstAid,CPR,certificationsandexpirationdates#!XX!_-#!_X!X ^$#-   andanyrelatedexperiencewithDevelopmentalDisabilities.Etc._____________________________________________  %X$. #!XX!_b.#!_X!X  ____________________________________________________________________________________________________ %%/ #!XX!_H/#!_X!X  ____________________________________________________________________________________________________ &%0 #!XX!_0#!_X!X  ____________________________________________________________________________________________________ f'&1 #!XX!_0#!_X!X18.#!XX!_1#!_X!X  Ifthereareperiodsoftimeinyouremploymenthistorywhenyouwerenotemployed,pleaseexplainthereasonand#!XX!_1#!_X!X ((`'2   thedates.___________________________________________________________________________________________ ("(3 #!XX!_2#!_X!X  ____________________________________________________________________________________________________ )(4 #!XX!_3#!_X!X  ____________________________________________________________________________________________________ n*)5 #!XX!_F4#!_X!X0  *****#!XX!_ 5#!_X!X  Notice:AllapplicantshiredwillberequiredtoshowproofthattheyareeligibletoworkintheUnitedStatesin 0+h*6 compliancewith#!XX!_`5#!_X!XԀU.S.ImmigrationLaw.Newemployeesarerequiredtopassapre#!XX!_E6#!_X!Xemploymentdrugscreen,provide +*+7 educationdocumentation,and#!XX!_6#!_X!XpresentanofficialcopyoftheirdrivingrecordfromtheDepartmentofMotorVehicles.,+8a&a& 0  NewhireswillsubmittoanFBI/#!XX!_[7#!_X!XDCI/DSFbackgroundcheckwithfingerprintsandareconditionallyhiredpendingthe v-,9 investigationssatisfactoryresults.****8.p-:a&a& #!XX!_?8#!_X!X  #!XX!_59#!_X!XICERTIFYTHATALLINFORMATIONCONTAINEDONTHISAPPLICATIONISTRUEANDCOMPLETETO#!XX!_9#!_X!X /.<   THEBESTOFMYKNOWLEDGEANDBELIEF.IUNDERSTANDTHATANYMISREPRESENTATIONOR#!XX!_:#!_X!X ~0/=   FALSIFICATIONSMYRESULTINREMOVALFROMEMPLOYMENTCONSIDERATIONORDISMISSAL.I#!XX!_:#!_X!X @1x0>   GIVEMCEITSAUTHORIZEDAGENTSPERMISSIONTOVERIFYANYINFORMATIONGIVENIN#!XX!_;#!_X!XCONNECTION 2:1?   WITHTHISAPPLICATION. 21@   #!XX!_7<#!_X!XSIGNATUREOFAPPLICANT:__________________________________________________,DATE:________________________ H43B AY)) xdE,O75%A    #!XX!_<##XXX!X#!XXXX!`iX!X P76F IMPORTANTINSTRUCTIONSFORCOMPLETINGTHEEMPLOYMENTAPPLICATIONFORMAGICCITYENTERPRISES 87I   #!XX!`i>>##XXX!X>#!XXXX!_X!X1)Youmustcompleteeverysectionoftheapplication.Incompleteorillegibleapplicationwillnotbeprocessed. :W9K   #!XX!_V?#!_X!X2)Youmayattacharesumewiththeapplication.However,aresumeisnotasubstituteforinformationonthisapplication ::L #!XX!_,@#!_X!X3)Thisapplicationisvalidfor90days.IfyouhavenotheardfromMagicCityEnterpriseswithinthattimeandstillwishtobe ;:M Ѐconsideredforemployment,youmustfilloutanotherapplication. e<;N      4    <      D     03/2006  =!=P #!XX!_@##XXX!X7?#!XXXX!`iX!X  DONOTSUBSTITUTEARESUMEINTHEPLACEOFTHISAPPLICATIONORANYOFTHEPARTSOFTHISAPPLICATION    #!XX!`iTC##XXX!X5C#!XXXX!_X!XWORKHISTORY:Startingwithyourpresentorlastjob,listyouremploymenthistoryforthelasttenyears. :r   #!XX!_kD#!_X!XEmployer:_______________________________________________________From:MO/YR___________To:MO/YR________ 4 Address:__________________________________________City:____________________State_______Phone_______________  YourTitle___________________________________________________Maywecontacttheaboveemployer?#!XX!_:E#!_X!XYesNo    #!XX!_F#!_X!XLastSalary:$______Per______#!XX!_jG#!_X!X HoursPerWeek:_____________Supervisor:______________________________________ Bz #!XX!_G#!_X!XReasonforLeaving:___________________________________________________________________________________________ < #!XX!_H#!_X!XDuties:___________________________________________________________________________________________________________  _________________________________________________________________________________________________________________   _________________________________________________________________________________________________________________ J  _________________________________________________________________________________________________________________  D  #!XX!_FI#!_X!XEmployer:_______________________________________________________From:MO/YR___________To:MO/YR________   Address:__________________________________________City:____________________State_______Phone_______________ R  ЀYourTitle___________________________________________________Maywecontacttheaboveemployer?#!XX!_K#!_X!XYesNo  L  #!XX!_XM#!_X!XLastSalary:$______Per______#!XX!_M#!_X!X HoursPerWeek:_____________Supervisor:______________________________________    #!XX!_&N#!_X!XReasonforLeaving:___________________________________________________________________________________________   #!XX!_N#!_X!XDuties:___________________________________________________________________________________________________________ Z  _________________________________________________________________________________________________________________ T _________________________________________________________________________________________________________________  _________________________________________________________________________________________________________________  ________________________________________________________________________________________ b #!XX!_O#!_X!XEmployer:_______________________________________________________From:MO/YR___________To:MO/YR________ $\ Address:__________________________________________City:____________________State_______Phone_______________  YourTitle___________________________________________________Maywecontacttheaboveemployer?#!XX!_jR#!_X!XYesNo  #!XX!_ T#!_X!XLastSalary:$______Per______#!XX!_T#!_X!X HoursPerWeek:_____________Supervisor:______________________________________ j #!XX!_T#!_X!XReasonforLeaving:___________________________________________________________________________________________ ,d #!XX!_U#!_X!XDuties:___________________________________________________________________________________________________________ & _________________________________________________________________________________________________________________  _________________________________________________________________________________________________________________ r _________________________________________________________________________________________________________________ 4l ____ .  #!XX!_jV#!_X!XEmployer:_______________________________________________________From:MO/YR___________To:MO/YR________ z" Address:__________________________________________City:____________________State_______Phone_______________ <t# YourTitle___________________________________________________Maywecontacttheaboveemployer?#!XX!_X#!_X!XYesNo 6$ #!XX!_Z#!_X!XLastSalary:$______Per______#!XX!_[#!_X!X HoursPerWeek:_____________Supervisor:______________________________________ % #!XX!_c[#!_X!XReasonforLeaving:___________________________________________________________________________________________ & #!XX!_\#!_X!XDuties:___________________________________________________________________________________________________________ D|' _________________________________________________________________________________________________________________ >( _________________________________________________________________________________________________________________ ) _________________________________________________________________________________________________________________  * #!XX!_\#!_X!XEmployer:_______________________________________________________From:MO/YR___________To:MO/YR________ "F!, Address:__________________________________________City:____________________State_______Phone_______________ ""- YourTitle___________________________________________________Maywecontacttheaboveemployer?#!XX!_;_#!_X!XYesNo #". #!XX!_`#!_X!XLastSalary:$______Per______#!XX!__a#!_X!X HoursPerWeek:_____________Supervisor:______________________________________ T$#/ #!XX!_a#!_X!XReasonforLeaving:___________________________________________________________________________________________ %N$0 #!XX!_vb#!_X!XDuties:___________________________________________________________________________________________________________ %%1 _________________________________________________________________________________________________________________ &%2 _________________________________________________________________________________________________________________ \'&3 _________________________________________________________________________________________________________________ (V'4 #!XX!_;c#!_X!XEmployer:_______________________________________________________From:MO/YR___________To:MO/YR________ )(6 Address:__________________________________________City:____________________State_______Phone_______________ d*)7 YourTitle___________________________________________________Maywecontacttheaboveemployer?#!XX!_e#!_X!XYesNo &+^*8 #!XX!_Mg#!_X!XLastSalary:$______Per______#!XX!_g#!_X!X HoursPerWeek:_____________Supervisor:______________________________________ + +9 #!XX!_h#!_X!XReasonforLeaving:___________________________________________________________________________________________ ,+: #!XX!_h#!_X!XDuties:___________________________________________________________________________________________________________ l-,; _________________________________________________________________________________________________________________ ..f-< _________________________________________________________________________________________________________________ .(.= _________________________________________________________________________________________________________________ /.> _________________________________________________________________________________________________________________ t0/? #!XX!_i#!_X!XPERSONALREFERENCES(#!XX!_xl#!_X!XPleasedonotlistfamilymembersorrelatives#!XX!_l#!_X!X) 101A #!XX!_Gm#!_X!XPleaseprovideinformationon(3)threepersonalreferenceswhoarefamiliarwithyourworkperformance. 21B   #!XX!_m#!_X!X      NAME#!XX!_jn#!_X!X  #!XX!_n#!_X!X 4 #!XX!_"o#!_X!X #!XX!_po#!_X!X #!XX!_o#!_X!X < TELEPHONE#!XX!_ p#!_X!X  #!XX!_cp#!_X!X D #!XX!_p#!_X!X  #!XX!_p#!_X!X  YEARSKNOWN |32C n  #!XX!_Mq#!_X!X_________________________________________________________________________________________________________________ >4v3D _________________________________________________________________________________________________________________ 584E _________________________________________________________________________________________________________________ 54F ___ 65G     ӄ#!XX!_q#! X!X#  !LD#!    #!XX !t#! X!XCompletionofthissectionisrequiredtosatisfyFederalEqualOpportunityStatisticalReportingandResearchRequirements.Thissectionwillbedetachedfromthe h98K applicationafterprocessingandwillnotbemadeavailabletohiringagencies.Employeesaretreatedduringemploymentwithoutregardtorace,color,religion, :>9L creed,gender,nationalorigin,age,disability,maritalorveteranstatus.Wecomplywithallgovernmentregulations,includingourAffirmativeActionresponsibilities :9M wheretheyapply.Asagovernmentcontractswearerequiredtoprovidereportscontainingthefollowinginformation.Yourcooperationisvoluntaryand B;z:N appreciated. ;;O #!XX !u#! X!XPositionappliedfor:_______________________#!XX !Vx#! X!X ReferralSource:Advertisement___Friend___Relative___Walk#!XX !x#! X!Xin___Other___________________________ ~<;P #!XX !Ry#! X!XEthnicGroup/Race:(CheckOne)Caucasian___AfricanAmerican____Hispanic____Asian_____AmericanIndian/AlaskanNative____Other_________________ =T=S      4    <      D     03/2006 󀀀  a&a&Qa& Aspartoftheapplicationprocess,pleasewriteabriefparagraphtothefollowingquestion: | Howwouldyoutrainadevelopmentallydisabledclienttowashtheirclothes?