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*Emergency Contact Name:
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*Position(s) of Interest:
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*How Did You Hear about Us?
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*Date Available To Begin Work:
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*Have You Filed An Application Here Before:

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*Have You Ever Held A Position Here Before:

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*Are You Currently Employed:

*Are You 21 Years Of Age or Older:

*Are You Legally Eligible For Employment In US:

*I understand that a valid driver’s license is required for ALL positions at Amego Inc.:

 
*Employer Name:
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*Employer's Main Office Address:
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*Positon Held:
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*Supervisor:
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*Employed From:
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*Employed To:
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*Summarize The Nature of Your Work and Job Responsibilities:
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*Reason For Leaving:
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Employer Name:
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Employer's Main Office Address:
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Supervisor:
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Business Phone:
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Employed From:
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Employed To:
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Summarize The Nature of Your Work and Job Responsibilities:
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Reason For Leaving:
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Employer Name:
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Employer's Main Office Address:
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Positon Held:
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Supervisor:
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Business Phone:
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Employed From:
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Employed To:
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Summarize The Nature of Your Work and Job Responsibilities:
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Reason For Leaving:
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Employer Name:
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Employer's Main Office Address:
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Positon Held:
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Supervisor:
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Business Phone:
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Employed From:
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Employed To:
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Summarize The Nature of Your Work and Job Responsibilities:
Please Summarize The Nature of Your Work and Job Responsibilities

Reason For Leaving:
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Please indicate if you have experience in assisting individuals with any of the following tasks:
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ADDITIONAL TRAINING/ SKILLS
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PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING AND RETURNING THIS APPLICATION
I understand that any misrepresentation by me in this application will result in the cancellation of the application and or termination from Amego’s service if I have already been hired. I affirm that all information contained herein is true to the best of my knowledge.

I give Amego and its noted agents the right to investigate all references, and all other information contained in this application, unless I have specifically written otherwise. I understand that failure to provide appropriate references may result in the cancellation, or withdrawal, of any job offer.

I understand that any initial offer of employment is conditional upon the results of all pre-employment protocol, satisfactory completion of all required training, and satisfactory job performance. I understand that my employment is for no definite period and may, regardless of the date of payment of wages and salary, be terminated at any time and without prior notice. I understand that no Amego representative, other than the Board of Directors, has the authority to make any assurances to the contrary.

I further understand that Amego will require a Criminal Offenses Records Investigation (Amego, Inc., has been certified by the Criminal History Systems Board to access criminal conviction data), BCI for RI Residents, Driving Record Check and documentation of eligibility for employment within the United States. Failure to comply may result in the termination of the employment relationship.

Amego is an Equal Opportunity Employer and does not discriminate in employment on any basis prohibited by local, state, or federal law. I understand that no information from this application will be used for the purpose of limiting or excluding any applicant’s consideration for employment on a basis prohibited by local, state, or federal law.

This application is current for only sixty (60) days. At the conclusion of this time, if I have not heard from Amego and still wish to be considered for employment, it will be necessary for me to fill out a new application.
*By Checking This Box I Agree To The Terms Listed Above:

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