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Merit

orporation
EMPLOYMENT APPLICATION

Complete the application online from the FBLA-PBL Web site. Use the tab key to move through the document.

GENERAL INFORMATION
Name (Last)
Verran

(First)

Address (Mailing Address)

(City)

(Middle
Initial)

Dalton

N/A

(Stat
e
)

N/A

E-mail Address

(Zip)

Home Telephone

() N/A -

Cell Phone

N/A

() N/A -

N/A

POSITION
Will Accept:
Part-Time

Position or Type of Employment Desired

pilot
Have you ever been employed at the Merit Corporation before?

Yes

Full-Time

No

Are you able to perform the essential functions of the job you are applying
for, with or without reasonable accommodation?
Yes
No

Date Available any time

Salary Desired

negotiable

EDUCATION AND TRAINING


School or
Institution

Name and Address of School

Major

Year
Graduate
d

Degree

Elizabthton High School


High School
N/A
College
N/A
College
N/A
Other
Special Abilities and Skills
N/A

aviation
N/A
N/A
N/A

Extracurricular Activities

Present Community and Professional


Affiliations

N/A

2017
N/A
N/A
N/A

avaition
N/A
N/A
N/A

Professional Certificates or Licenses Held


pilot licenses

N/A

Languages Read, Written or Spoken Fluently Other Than English


N/A

REFERENCES

List below names and addresses of persons who are qualified to answer questions concerning your fitness for the
position(s) you seek other than those listed in your credential file.

Name

Position

Address

Telephone

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

AN EQUAL OPPORTUNITY EMPLOYER

WORK EXPERIENCEMost recent first, include voluntary work and military experience
Employer N/A
Telephone Number (N/A) -
From (Month/Year)
N/A
Address N/A
Job Title N/A
Number Employees Supervised 0
To (Month/Year)
N/A
Specific Duties (Maximum 350 characters)
N/A
Hours Per Week
N/A
Last Salary
N/A
Supervisor
N/A
Reason For Leaving N/A
Employer N/A
Address N/A
Job Title N/A
Specific Duties (Maximum 350 characters)
N/A

May We Contact This Employer?


Yes
No
Telephone Number (N/A) -
From (Month/Year)
N/A
Number Employees Supervised N/A To (Month/Year)
N/A
Hours Per Week
N/A
Last Salary
N/A
Supervisor
N/A

Reason For Leaving N/A


Employer N/A
Address N/A
Job Title N/A
Specific Duties (Maximum 350 characters)
N/A

May We Contact This Employer?


Yes
No
Telephone Number () N/A -
From (Month/Year)
N/A
Number Employees Supervised 0
To (Month/Year)
N/A
Hours Per Week
N/A
Last Salary
N/A
Supervisor
N/A

Reason For Leaving N/A

May We Contact This Employer?


No

Yes

I certify the information contained in this application is true, correct, and complete. I understand that, if
employed, false statements reported on this application may be considered sufficient cause for dismissal.

Signature of Applicant_________________________________________________________ Date________________

AN EQUAL OPPORTUNITY EMPLOYER

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