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STEVENS INTERIORS, INC. Today's Date Fall Name: (hand) Tere, aa ‘Social Security Number? Driver's License State amber (Fire you at tease 18 years of )_No( _) Can you legally workin he US? Ves) Nod) [Rar atares: Sweevro box f Cay: Sims ip Coan [Phone Namiber: Home. Work) cay i Position Desired: Foroman( ) Lead man()Framer() Hanger) Flaher( ) Laborers) ‘Acoustical tustallor (_) PIast@r/ELFS Installer) _Apprenticn(_) Laborer) Other) Dasived Rate of Pi ‘Date Available for Wark: Teer hour S Ter wack Previous Employer (at mast currant ra ‘Company Name: ‘Adie Positions Dates employed ‘Reason for leaving Phone Namibers Supeniocs Name May wc contact enployer? Yast) = Neca Civic Race Phove Number: (_) “Address Position ‘Superviaors Name: Dates eropiayed = May we contnot employer? Vent) Nec) ‘Reason for leaving Tiave jou cver been employed by Stevens Interiors ine‘? Veet —y Nac) yen when ‘Wheres ‘Hiss di you hear shoal Stevens Infariors Tao? Newspaper ( —) Relative) Friend ¢—) Others an employee of Sil wold you about appivinn here please give Orman: smergency Contact Retationeip: ‘Phone Number: (_. Tcertfy that alt suswers given by mo ws well as statoments are true and correct without omissions of any Kind. Tngree trav diay be terminated from employment in fact Servens Inferiare, fue: dcterinines that t fave matte talee answers statement (or omissions during my job interview or on this application, — Date: FOR OFFICE USE ONLY Date of employment: Location: Division —_ Pay rate aureed by Management $_——/perhour OR Tp wack Position agreed by Managemen: Foreman( ) Mechasic( ) Apprentiee(') ‘Laborer( ) Offise() Par Time( Romar Management Signature