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Virtual Learning Academy 1820 michigan Ra. Por Huron, 48080 (310) 364-t362 Employment Application ie va mi, > nies: _____—dT8S_Wadhams Q ale TF St. Clair ME O74 ey “ine cn Prone: (812) 858-443 enai_ acolo mgerca hoo com Date Avaliable: Sect Secuy No Dosis Salany'S Psion Applic for: Ys 10 Ys 10 ‘Are you ciizenofthe Unies states? Etro, areyouautorzedtowokin meus? ‘OO Have you aver wert torticomsany? "ED EP yen nen? Have you over bean convced otatelny? “ES yes, expan: ign sotoot Wichval Learning Aer? Gye, S20 Mcchican Ro Pot Huron MP 2 ves no 80% From 2916 ty 2217 pisyougraduater "EJ Diploma conege: cer Yes No From re: Didyourecuate? EE Deges: other pesos: From: 1 Didyougraduate “EP TP Degree: eae ttre protssionareerences ratnane Flos company rove ies Ful Name: Relation Company Phone arose: Ful Name: Relationship: company Phen ‘Aches BESviGUs EMplOVENt Company Phone: ast: Superior. ob Tie Stating Salay'S Ending Satary$ Responsbites: From: To, Reason for Leaving: es no May wo contact yourprelous superior or areterence? ED ‘company: Phone ares: Superior Job Tite Stating Salay'S Ensing Salane$ Responsbites: From Te Reason or Leaving: ves no May we contact your previous supenisortorareferenes? §) ‘company: ie Phone ares: superscr sob Tite: Starting Salon's Enaing Salon's Responsbites: From 1 Reason fer Leaving: May we contact your previous superisorfora ference? “) ranch: Fro: 1 Rank at Discharge: ‘Type of Dechare: It ther than honoree, explain: "cent my answers rete ad comple oe es of my rowed. 1 thie apocation leads to employment, J understand that flee or misleaing information in my appliaion or interview may rast in my release.

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