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!YN '• r <br /> W E R ALL QUESTIONS PLEASE PRINT <br /> Date of Application. 7?-le'elSxZZ <br /> lis er Social Seeny No . <br /> ;. <br /> t Address �L,06) RR 2 rg,�0 /_C-P <br /> To ate <br /> Street *ty or . o <br /> Home Telephone <br /> e- you known to schools refe enc s by another name. Yes No_, <br /> If yes, by what name? <br /> � . . <br /> se of emergency notify : <br /> in r r � P orgy ��`��41 <br /> case <br /> Address :, <br /> * <br /> Street City or Town state Zip Cede <br /> o filed an application been employed by the Town of ashp-ee <br /> Have � ., <br /> before? Yes No � <br /> If yes, what department?etden <br /> Air - you a citizen of the United States? Yes <br /> If not, do .you, have an Alien Registration Card? Yes No. x <br /> rlelatd to anyone in Town e-wjy, please state : <br /> ame ---Department <br /> Have you been employed by Massachusetts gtat'e, unty, it -p vxjwn or. any � <br /> Massachusetts Public Authority? Yes <br /> If yes, within 2 years? Yes No <br /> S ; <br /> Position Applied For: I <br /> Date you can . start -' Are currently employed? ' <br /> ns to ed Jh&1-101"L <br /> .May we i.n uire of your present employer? <br /> Are <br /> mploye - <br /> re ou a . Veteran? Yes N o V If fires, Branch of Service <br /> lease li-s—t--3 references not related to you. <br /> 5 <br /> Name Address Phone Number <br /> �,e_ly,1jF <br /> 10" <br /> 20 <br /> } <br />