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TOWN OF ORO VALLEY
130 E. C. Concord , ,._r
- LICATION F( R EMPLOYMENT
___________
PERSONAL INFORMATION �
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Name dr.-----x—')Lk e•-f\0 f,� k-i\--(1.- �� ';Age Sex w
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Last First Middle •-'
Present Address4. .________ /-** , (,---
3City State Zip
Permanent Address ., ; \. ---, • 'Jr,('''''.-\:\ ) .- (2, '., \ \(7.‘,._ i
Street City State Zip
Phone Number — Own Home Rent Board
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Color Color
Date of Birth , 1 r Height 4---//,..,:,_.:;—,�, Weight 1 : 1 r.„, of Hair L(' k{ -- 'i `r of Eyes `�_�1 1,""'k 7 ,
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Married Single )1N, Widowed Divorced Separated
Dependents Other Citizen Yes K -T•'-
Number of Children '\ Than Wife or Children .` of U. S. A. No 0 il.
If Related to Anyone in Our Employ, Referred
State Name and Department By
EMPLOYMENT DESIRED
•
Date You Salary
y c.
Position Can Start c---
' --'{~- .) Desired (, ")Ci`f j, K
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If So May We Inquire ,, a
Are You Employed Now? ,, • -`1 of Your Present Employer A,.T.. `�
Ever Applied to this Company Before? ,-.,....-; Where , --..., When —
EDUCATION Name and Location of School Years Date
Attended Graduated Subjects Studied
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Grammar School . � - --s l'�-):.-- �C�Q---. `r- -c-_`-
(70 E--Nc\k..)F 20 ,i\&vc...) . 1 L.,,,--,-) ,........_.....,....._
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High School - -- (-' 111
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College VAC..).-k.)4 .,
!e\` "('"..`.•) r) , "r--, —ar. �w. 1..\-tr �,� Cit.^l)S�r 'v 't I ,.r...�
Trade Business or ,� A a flw. � y
Correspondence nk\e.. . .,
SchoolaC2,61.7)\,t_______AC, : �_�
Subjects of Special Study or Research Work
What Foreign Languages Do You Speak Fluently? _ -- _s, _r\,K__ Read 1.-6- ”" Write ,. .-
U. S. Military or ,,_._.._- Present Membership in �._.�T
Naval Service Rank —National Guard or Reserves
Activities Other Than Religious --- - `'� rlz
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(Civic, . (--.) ,
Athletic, Fraternal, etc.) (2/(:_..... ))A, 7---i-C a)- t` ,.• -- y,,'- ' -' .p- -
EXCLUDE ORGANIZATIONS,THE NAME OR CHARACTER OF WHICH INDICATES THE RACE, CREED,COLOR OR NATIO14A1 ORIGIN OF ITS MEMBERS.
(Continued on Other Side)
Form 660-26 U. S.A. WILSON JONES APPLICATION FOR EMPLOYMENT
$FORMER EMPLOYERS (List Below Last Four Employers, Siarting With Last One First) •
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Date
Month and Year Name and Address of Employer Salary Position Reason for Leaving
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REFERENCES: Give Below the Names of Three Persons Not Related To You, Whom You Have Known At Least One Year.
,
. Years
Name , Address Business
Acquainted
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PHYSICAL RECORD:
List Any Physical Defects L)C.:}N)E,
Were You Ever Injured? KVGive Details
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Have-You-Any Defects In Hearing? 5' - - In Vision? \,„..) In Speech? \\,:j c--• )
In Case of #-_.-. c:7)
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Emergency Notify 1.- -, ‘,\ ...._. -,-,... if ;::,, ,' -_-;:(--,---
Name Address ‘ Phone No.
I authorize investigation of all statements contained in this application. I understand that misrepresentation or_omission of facts called for
is cause for dismissal. Further,I understand and agree that nw-employment is for no definite period ard-riia ,regardless of th-e-d te of payment
of my wages -.. salary, be terminated at any time without\anurevious notice. `‘ (1/4„,
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Date A- -----\ 7---.'1 - - .7/ -4, Signaturer----''\ -1-77(l',%,,,i\j\.; ..F- t ,'4-Th---- ' '1 i • /
DO NOT WRITE BELO'V THIS LINE
Interviewed By . Date
REMARKS:
Neatness Character .
Personality Ability
Salary
Hired For Dept. Position Will Report • Wages
Approved: 1. 2. 3.
Employment Manager Dept. Head General Manager
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