First Name Last Name Street Address City State Zipcode Email Address Phone Number Current Or Previous Employer Experience Education High School or Equivalant Some College Currently Enrolled Some College Graduated College What location would you prefer to work Kennett Caruthersville Sikeston What locations can you work? This will be considered when review the applications. Select all that apply. Are there any days or hours from December through April that you can not work? If so please list them. What days are you available during the week? What hours are you available during the week? What days are you available during the weekend? What hours are you available during the weekend? Do you have replaible transportation? Yes No If you have dependants or children do you have reliable childcare arrangements? Yes No Not Applicable

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