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  • Contact Information
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    City, State OR Zipcode
  • Employment Information
  • *Check RFR for the type of employment terms allowed for the position*
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  • Also, may try to confirm whether or not candidate is U.S. Citizen; however, can not ask this question directly.
  • Voluntary Information - will not be used when considering your employment:
  • List the name of a reference, contact information, and number of years known:
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