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Address: PO Box 391 Union City, IN 47390 Call: 800-518-8971

Employment Application Form

Structured Solutions, LLC

First name*

Last name*

Email*

Phone*

Address*

Date Available to Start Work*

Desired Pay Amount*

High School Attended*

Graduated?*

Yes

No

College Attended

Graduated?

Yes

No

If so, what specialty?

Reference #1 Name*

Reference #1 Phone*

Reference #2 Name*

Reference #2 Phone*

Reference #3 Name*

Reference #3 Phone*

Previous Employer*

Supervisor Name*

Phone Number*

Job Title*

Ending Pay Amount*

May We Call/Text You About This Application?*

Yes

No

I accept the privacy policy and I give my express consent to Structured Solutions , LLC to treat my data for the purpose of sending of commercial communications and administration of the contracted services, as applicable.

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