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| *First Name: |
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| *Last Name: |
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| *Address: |
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| Address 2: |
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| *City: |
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| *State: |
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| *Zip
Code: |
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| *Phone: |
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| Cell Phone: |
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| *Email
Address: |
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| *Postition Desired: |
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| *Salary/Hourly Rate Desired: |
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| *Available
to work: |
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| *Date available to begin work: |
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MM/YYYY |
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| *Have you applied for employment here before? |
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Yes
No |
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| If yes, date: |
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MM/YYYY |
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| *Do you have the legal right to be employed in the U.S.? |
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Yes
No |
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| *Are you 18 or older? |
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Yes
No |
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| If under 18, Work Permit #: |
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| Do you have reliable transportation to and from work? |
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Yes
No |
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| Do you currently have a valid driver's license? |
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Yes
No |
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| Has your driver's license ever been revoked, suspended or restricted? |
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Yes
No |
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| If yes, for what reason and how long? |
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| List any moving violations during the last three years. |
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| Have you worked under a different name before? |
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Yes
No |
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| If yes, please explain: |
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| Other special training or skills (languages, machine operation, etc.) |
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| How did you learn of Lamar? |
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| AN EQUAL OPPORTUNITY EMPLOYER: It is the policy of the Company to afford equal employment opportunity regardless of a person's race, religion,
color, national origin, sex, marital status, height, weight and/or
disability. |