ONLINE EMPLOYEE APPLICATION Please complete the Application form below. Fields marked with an asterisk (*) are required. Position applied for:* Store AssociateAssistant ManagerCleanroom TechnicianWarehouse Staff Location Applied For:* 68th StreetAlpineBenton HarborCorporate OfficeFullerGrandvilleGrand HavenHastingsHollandLowellStandaleWarehouseWest River Drive First Name:* Last Name:* Date of Birth:* JanFebMarAprMayJunJulAugSepOctNovDec 01020304050607080910111213141516171819202122232425262728293031 202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940 Telephone:* Email (Optional): Address: ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY How long have you lived at this address?* Do you have reliable transportation?* YesNo If under the age of 18, can you produce the necessary work certificate at the time of employment?* YesNo Type of employment desired:* Part-TimeFull-Time Desired number of hours per week:* Desired Salary/Hourly Rate:* Are you willing to work overtime?* YesNo Have you previously applied for employment with this company?* YesNo If yes, when and where did you apply? Have you ever been employed by this company? YesNo If yes, provide dates of employment, location, and reason for leaving employment:* Please attach a copy of your resume with education, work history, and references.