Work Experience
Give past work experience, including service performed as an independent contractor, as completely as possible, starting with your most recent work experience. Include summer employment and unemployed or self-employed periods; Show dates and locations.
Employment #1
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Present or Last Employer
Address, City, State, Zip Code
Telephone
Name and Title of Immediate Supervisor or Person to Whom you Reported
Last Position You Held & Salary
Reason for leaving
Employment #2
From Month January February March April May June July August September October November December Year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920
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Employer
Address, City, State, Zip Code
Telephone
Name and Title of Immediate Supervisor or Person to Whom you Reported
Last Position You Held & Salary
Reason for leaving
Employment #3
From Month January February March April May June July August September October November December Year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920
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Employer
Address, City, State, Zip Code
Telephone
Name and Title of Immediate Supervisor or Person to Whom you Reported
Last Position You Held & Salary
Reason for leaving
Employment #4
From Month January February March April May June July August September October November December Year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920
To Month January February March April May June July August September October November December Year 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920
Employer
Address, City, State, Zip Code
Telephone
Name and Title of Immediate Supervisor or Person to Whom you Reported
Last Position You Held & Salary
Reason for leaving
Ballard Brothers Fish Co., is an equal opportunity employer and does not discriminate on the basis of race, color,
religion, age, sex, national origin, non-disqualifying disability, genetic information, veteran/military status, or any
other characteristic protected by law.
Agreement
On entering the employ of Ballard Brothers Fish Co. (Ballard), I agree to observe all the rules of my employer and any governmental regulations that may apply to my duties. I understand that any continuation of my employment will depend upon satisfactory replies on any background check and from my references and performance satisfactory at all times to my employer. I understand and agree that my employment is for no definite period of time and may, regardless of the date of payment of my wages and salary, be terminated, with or without cause or notice, and without liability for doing so. I understand that no representative of Ballard, other than its President, has authority to enter into any agreement for employment for any specified period of time or make any agreement contrary to the foregoing, and that any such agreement, to be enforceable, must be in writing and signed by the President.
I further consent to any testing as may be required by Ballard, including, but not limited to, drug and/or alcohol testing.
I certify that the information provided herein is true and complete to the best of my knowledge and belief. I understand and agree that providing false, incomplete, or misleading information will be grounds for a decision not to employ me or to terminate my employment immediately without liability for doing so.
Electronic Signature
Date