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How Do You Start an Llc in New York

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					                           Wave Comm GR, LLC
                            113 North Genesee Street
                             Utica, Ne w York 13502
                                 Phone (315) 533-1244
                                  Fax (315) 533-1258

                          Employment Application
                                 (Please Print Clearly)


                                    Personal Data

Name ____________________________                                  Date______________

Present Address____________________________________________               ____________
                                                                          Apt/House #
               _________________________________________________
                    City               State               Zip

Date Of Birth ______________________                        SSN _____-_____-_______


Phone Numbe r (      )____________________           Cellular Number (        ) _________



                                     Job Inte rest

Position Applied For ______________________________________

Indicate Availability To Work:     Full Time   Part Time Days
                                      Evenings     On-Call
Year/Make/Model of Vehicle __________                _______________          __________
                                 Year                       Make                 Model

Do you presently hold a VALID Drivers License ?            Yes         No
If yes, please provide State of Issue and Document Number: ______________________
                                                               State      Doc. Nu mber
Can you provide proof of insurance?                 Yes                 No
Date you are available to start _________________________

Referred By : _______________________________________

Have you ever been employed by Wave Comm GR LLC before?                             Yes            No
If Yes, Please indicate Month/Day/Year and last Position Held: ____________________
                                                                                   Month/ Day / Year
______________________________________________________________
              Last Position Held


Are you legally permitted to work in this country?                Yes              No
Do you have any preexisting medical conditions that would not allow to perform the
responsibilities and duties of the job you are being considered for ?
 Yes  No
Have you ever been convicted of a felony?  Yes *       No
If yes, please explain: _____________________________________________________
________________________________________________________________________
________________________________________________________________________

       A positi ve response will not automatically bar you from empl oyment wi th this company.
        The offense for which the person was convicted in rel ation to t he position for which they
        have applied for will be considered.




                                               Education
Please list all schools attended post secondary. Attach a separate paper as necessary, or continue on back.

 School Name                    School Address                     Courses        Graduated? Degree
                                                                   Studied                    Type
                                        Empl oyment History
   (List previous empl oyers beginning wi th most recent. Please expl ain any g aps in empl oyment.)


Company Name _________________________             Business Type _____________________________

Address ________________________________________________Phone Number ________________

Supervisor ______________________________          Supervisor Ti tle ______________________


Position ________________________________          Full Ti me Part Ti me Temporary
Empl oyment Dates (mm/ yy): From __ __/__ __ To __ __/__ __          Ending Sal ary: _________


Reason for Leaving : _______________________ May we contact:         Yes        No

Company Name _________________________             Business Type ______________________________

Address ________________________________________________ Phone Number_________________

Supervisor ______________________________          Supervisor Ti tle ______________________


Position ________________________________          Full Ti me Part Ti me Temporary
Empl oyment Dates (mm/ yy): From __ __/__ __ To __ __/__ __          Ending Sal ary: _________


Reason for Leaving : _______________________ May we contact:         Yes        No

Company Name _________________________             Business Type ______________________________

Address _____________________________________________ Phone Number _________________

Supervisor ______________________________          Supervisor Ti tle ______________________


Position ________________________________          Full Ti me Part Ti me Temporary
Empl oyment Dates (mm/ yy): From __ __/__ __ To __ __/__ __          Ending Sal ary: _________


Reason for Leaving : _______________________ May we contact:         Yes        No

Company Name _________________________             Business Type ______________________________

Address ________________________________________________Phone Number ________________

Supervisor ______________________________          Supervisor Ti tle ______________________


Position ________________________________          Full Ti me Part Ti me Temporary
Empl oyment Dates (mm/ yy): From __ __/__ __ To __ __/__ __           Ending Sal ary: _________


Reason for Leaving : _______________________ May we contact:          Yes         No


                                      Professional References
                           (Please list three professional references below)

       Name                  Company and Title         Business Telephone           Home Telephone




I declare that the facts set forth in my applicati on are true and complete. I understand that if I am
empl oyed, false informati on stated in this applicati on shall be sufficient cause for dismissal.


Applicant Signature: _______________________________________                   Date: _______________




                                                                                                WF 101

				
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