McDowell County Commission on Aging Employment Application Step 1 of 4 25% Personal InformationDate* Social Security Number*Name* First Middle Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Phone*Are you 18 years or older?*YesNoAre you either a U.S. citizen or an alien authorized to work in the United States?*YesNo Employment DesiredLocation applying to:Welch Senior Center FacilityBradshaw Senior Center FacilityPosition*Date you can start?* Salary desired*Are you employed now?*YesNoMay we inquire of your present employer?*YesNoEver applied to this company before?*YesNoWhere?*YesNoWhen?*YesNoReferred by EducationName of High School:Location of High School:Number of years attended - High School:Did you graduate High School?YesNoHigh School subjects studied:Name of college or trade/business school:Location of college or trade/business school:Number of Years Attended - college or trade/business school:Did you graduate college or trade/business school?YesNoCollege or trade/business school subjects studied: GeneralSubjects of special study or research work?Special skills?Activities (Civic, athletic, etc.)?Do not include organizations which indicate race, religion, sex, age, marital status or nation of origin of its members.Military service?YesNoRank?Active?YesNoDischarge date?