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Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Mode of Transportation

Birthday

Do you have a valid Driver’s License?

Are you a Smoker or a Non-Smoker?

Do you have any visible body art or piercings? (explain)

Education

What was your school, course of study, dates and degree earned?

Work History (With References)

Would this be your only place of employment? If not, where do you work?

Do you prefer part-time or full-time?

Experience with natural health, supplements, retail, etc.

Describe your personal eating habits:

Cooking Experience:

Personal Interests:

Why do you want to work at The Natural Marketplace?

Future Plans (in the next five years):

What do you consider as a personal challenge in the workplace?

What skills would you bring to the workplace?

Availability:

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What hours would you be available to work?

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