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A x • � �1��o��t �iStory �xpe�-ienc� a�d �ra��ing r�ings are d�te�-rnin�d by t�fs infor�at��n_ �'�ease �e ct��ete_ L�st �nost c�ecent em��oyers ffs�_ {�se add��iona� s�e��s � � �ecessa�_ ) . . _... . :. .. �..:::: _._. _._::.._,.._ ..... .._�..-Zi�.�.. _.:: ��::..,.. .::..: . . ...:..� -.:. Address Ciry S�ate �� o �� . ��+D�D . �� � � �� o� �`'%� 5��.�'� Su rv�so� `I`it�e &�ame Pfiflne No. Ma}� we con�a�t� Ctl' !C �'f'1 ��l` ' � � �" .�� 1 � /� �I� /� � Yes �fl Da��s of Ernp�4y�e�t o�rs �Tor�Ce ee�C .�oh `T�tle ��-� �t� rf " �.ast Sa�ary ar Hour�y 1�ag� �� '�� --- �� '�'1 �" �� j �'Io�' ' � �� {'I�'t f l � �C.� �l `�' � 1 !� �S� �Zeaso� fo� Leaving= � 1� ��r s-� � S�e �� C�r��r+ � ��t-� � #- • - Pri G /' �� , e -�� S�eY'�:� c s •� ••�:� � r��' �peci f c Duiies. • �t�a f�. a� �ti� e �{t �K t�or� �.c� � �,.; ��1 ��ft �: ��i � � q � �� 111 � � � ,� % � �;1��•� � � �s � �r� � � � � • �� an�j ��r-�' }�r�r � �� o�; - � Pnc�� � � J • �}tt�;�� ac �'t � � .� r��1 s � r,�ti /�: t�� P �.� �i or� � . � t � -� o -� -e � � � ,� p� �� �'�P .� � � ��-�-�; �-� � � �s � -�-r ��, � �i �►� �cfo � � � �-�'�► ��1 c �' �� � � �° � ` �� t �� Q��i! i� i �iGi�j G�Jl,� ��i3 O� ; �'��j o � o � �° �' � 1'� y ' �'� C+ ��/�G� ir�C,�? r' �O�' ��: L� i r�� /�C: n q r��i� E'l? � / � � � ' �� : � ,� ��' ;� f� �'; �� e�-��-� � � a �l �Cf /L�CI! J•'! h'i� Gl 11 �%/I G�'i �� {�'��f/ ��/ � � �'C � i �/ �! ��—�Cl�! �G. � ��, � S �� c� � �� P �� _ __ . .._ _._._ _. __._ _._: .:.....:....:Y_.T__�c._.�:_ ..ry..:.s. �:.-�:...: _ _ .�.. _.,f:t:. _ . . .:. .: .. .. .... ..:._. n. ...::.:.:.: . ..✓.. � •�:. � ..�.�. :.i .Y.. : 'Jv .:-% - Y. .ry. •'�i:' Y�' `-�-0-:..rvf�f:.Yti ' ....'.r? ' . . v , �.. �: . . . . ..': �:y'::•.v` . ....:.��>. : �_ � i.:. �l.,yl: .�-��i.. . : . .. .. . � •% ,.;i.:;.-.. .:...: :.. : :� _...x.:..�. ::r%� w.'A:aY . . t.:.+....� . ...... .-. _�.... :�.:.::.-_,.. ' '. • �.�� ..� .:.:: .<.`. �-�.:: «•v...: ..,.. , -" .. J �:.�,: ; - ;:, . : - �,;...�::.. ` ''�La.':ns:G :�::i�:`Sr.:A::Sa.'"`t�:.:•""^?�� Address. . . .. ... . .:�.. ......... �..:...�, :�_�.�_ �.-: �. r � �. s .r, . �� .State Zi� � �� „� � � , ; ; � . � �. � . � � � � �� � � � �� 1 ��'� �� �� Superv�sflc Tit� &�iame P#�one �io_ A-� j��#;,�� iay we co��act� Af �C 3�• �i � � �'�1 � S C� �.�•� r � ��°� Yes Nfl Dates t�f E�plflyment Ho�rs �larke�leek .�ob `�'it�e �rt 4�1'�ol; � i.as� Salary or Hourly i�age � �a �t�� S' -- �c � o��a �' 0 �' _ ��'��o �� 1'1�� r ��,4G1�1 r. Reasor� fof Leav��g: '` � Spec-�c fli�t�es: / • : � ��v� �� ,� � �!t S�1S A�t.t u�� 1?�f � t�E' � � � � �� � � � � �� ' �� v� S� }��r� ��%a�� y�� rn��1� � �;��:�� � � � p P � a � �''� � f� �� St., � � : � �-G�� G �: Cr� �; or1.S � � �� • ��I� � �� "� �J�- a � �vJ �c�eY�el �' iC� � l O • �� � 0� � � �� t�rt�� r�`-��i ��iG A�� y4 ��n� or� A 1� s� �o � � S e� � � lt°��y-� .��r �' o �'S l 1 � � � � � � • � i � � i� .S �l'�? T � 1 � �&�rrl; �I f�C �k 3 � .S'�� '_ �'10��1' r �rr � • . � /�!�►C� S � S f0 � �� C� �� � � � � � p � � ' ��t � � 1� � � S -��' � � S� � � t;�j��o r��i1 �' tf '� (,-� ��j Pr � � � �� ,� � � � � � �,�a 1 �� r r, � �r� - �� _ . ��D S�� , � ��C �Cv.� m P.�l.l�� 'lan� � �: �• ��c. �t. � o'r 4� �ir, ,,� � 1 �� 1 � t e� �.' • �c� � � � 7 �i�� lI � G�c �O/l�Q � �Y� � G n� �l f�' �G•� E� �. � Or10 ��-�la � �� - ��, �! �� � � City of A�der� Hi1is * 124� V�/�$t #-i�gfi�va}� �fi, Ard�n �ii�s, A1i� �� 2��s5 �� 792-7Sfl0