20%
Questions marked with a * are required Exit Survey
 
Contact Information
* First Name : 
* Last Name : 
Address 1 : 
Address 2 : 
City : 
    State     Zip
* Phone : 
* Email Address : 
 
 
* Desired salary:
   
 
 
When can you start?
MonthDayYear
  
 
 
Yes No
* 1. Are you presently employed?
* 2. If so, may we contact your current employer?
* 3. Have you ever been convicted of a felony?
* 4. Have you previously applied for a position or worked for NLUC?
* 5. Are you under 18 years of age?
* 6. Do you require any special accommodations to perform essential job functions?
* 7. Are you legally eligible for employment in the US?
* 8. Do you have any relatives presently employed at NLUC?
 
 
 
Explain any "Yes" answers for questions 3,4,6 or 8 above: