Personal Details Last Name: Kearney

Applicant First Name: Kamrin

Please Type or Complete in Black Ink

APPLICANT DETAILS
POSITION Have you ever worked
APPLYING FOR:
Job Title: Publix here before? no
Have you ever been convicted of a
felony? Please explain.
No

How did you hear about this job?

It was recommended to me by friend
Title (please check) Ms. Miss Mr.

Street Address : 197 Baywood lane

City/State/Zip: Villa Rica Georgia 30180
Contact Details : Home Telephone No. 301 661 1636
Email : Kamrink07@gmail.com

EDUCATION
Name of School Attended From: Awards/Honors:

August 2021-June
North point High school
2022
August 2022-
South Paulding high school
present

PERSONAL STATEMENT: What is one thing that you can offer your employer?
I can offer my employer my working initiative and persistence

CURRENT EMPLOYER
Name: None
Address: Zip Code:
Supervisor: Business Telephone: (Contact Y / N )
Length of Service:
PREVIOUS EMPLOYER
Name: None
Address: Zip Code:
Supervisor: Business Telephone: (Contact Y / N )
Length of Service:
REFERENCES
Name: Steven Schdell
Address: 1364 Winn Rd, Douglasville, GA Zip Code: 30134
Email: Sschdell@paulding.k12.ga.us Daytime Telephone:

Name: Michael Wilson

Address: 52 Industrial Park Dr #23, Waldorf, MD Zip Code: 20602
Email: Daytime Telephone: 301 932 9888
SIGNATURE: DATE:1/9/2023
Kamrin Kearney