Full Time     Part Time     Other                      Date Available:

Yes     No >>>> If No what is your Visa Status Alien Registration No.

Yes     No     (If Yes, Please Explain)

Name: Location: Course of Study:

Dates Attended:  From To

Did you Graduate? Yes     No

Degree or Diploma:

Name: Location: Course of Study:

Dates Attended:  From To

Did you Graduate? Yes     No

Degree or Diploma:

Name: Location: Course of Study:

Dates Attended:  From To

Did you Graduate? Yes     No

Degree or Diploma:

Name: Location: Course of Study:

Dates Attended:  From To

Did you Graduate? Yes     No

Degree or Diploma:

Stenography: W.P.M.      Typing: W.P.M.

What Other Office Equipment do You Operate:

State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Classification:       Number: 

State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Classification:       Number: 

State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Classification:       Number: 

State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Classification:       Number: 

State: Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Classification:       Number: 

Address:

Employed From: To:    Name of Supervisor:

Salary:  Start   End   Hr.  Wk.  Mo.  Yr.

Job Title:

Duties:

Address:

Employed From: To:    Name of Supervisor:

Salary:  Start   End   Hr.  Wk.  Mo.  Yr.

Job Title:

Duties:

Address:

Employed From: To:    Name of Supervisor:

Salary:  Start   End   Hr.  Wk.  Mo.  Yr.

Job Title:

Duties:

Address:

Employed From: To:    Name of Supervisor:

Salary:  Start   End   Hr.  Wk.  Mo.  Yr.

Job Title:

Duties:

Period of Active Duty: From: To:  

Rank At Discharge:

Describe your duties and Special Training

I voluntarily give Cambridge-Lee Ind. L.L.C. the right to make a thorough investigation of my past employment and activities, agree to cooperate in such investigation and release from all responsibility all persons, companies or corporations supplying such information.

I consent to taking the post-offer physical examination and such future physical examinations as may be required by the company.  I understand that such physicals may include testing for drug and alcohol abuse and consent to such testing. 

I give consent for the release of the test results to authorized company management, and release all parties from all liability for any damage that may result in furnishing information to the company.

I agree that the entire content of this application form as well as the report of any such examinations, as may be required by the Company in whatever manner it may wish.

If employed by Cambridge-Lee Ind. L.L.C. I understand that any such employment is subject to the security policies of the company.  I agree to wear or use appropriate clothing or safety devices as required by the company and to comply with the safety rules.

If employed by Cambridge-Lee Ind. L.L.C. , I understand that any such employment terms of employment would not constitute a contract of employment for any specified duration and is terminal at will of either party.

If employed, I agree to conform to the rules and regulations of Cambridge-Lee Ind. L.L.C.

I further understand that any false answers or statements made by me on this application or any supplement thereto, or in connection with the above mentioned investigations, will be sufficient grounds for immediate discharge.