Positive Maturity AWARE Program: Application

Positive Maturity Actitivies for Senior Adults

AWARE
Aging Workers Are Reliable Employees

Select Job Category

This application is for pre-screening by AWARE and does not replace applications required by the participating company.

Job Application
First Name:	MI:	Last Name:
Address:
City:	ST:	Zip code:
Phone:		Cell:
Date of Birth:	Gender: Status:
Skills/Training:
Do you own a car and have a valid Driver's License?			License #:
Have you been convicted of a crime in the last 10 years?
If Yes, Describe:
Do you have any physical defects which will prevent you from performing certain kinds of work?
If Yes, Describe:
Education Level Completed:		Other Training:
Work History (Enter Last Employer First)
Employer:		From to
Duties:
Reason for leaving:
Employer:		From to
Duties:
Reason for leaving:
Employer:		From to
Duties:
Reason for leaving:

All information contained in this application is true and correct.
This is your signature, Enter your full name:

AWARE EMPLOYERS
Affinity Home Hospice
Airport Express
Episcopal Place
First American Bank
Regions Bank
Manpower
Securitas
Printer Connection
MAX Transportation
Sunny-Side Up Nursery
Embassy Suites
Sheraton Birmingham
St. Andrews Place
First Pro
BJCC
Prime Time Treasurers
The Parker Group
Home Options
Home Instead
Long – Lewis Ford
TeleTech
Moore-Handley

Partners

Positive Maturity
3918 Montclair Road
Birmingham, AL 35213
205-803-3211