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Name

Address

Town/City

Postal Code

Phone Number

E-mail Address

Age

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I have smart serve

I have a valid drivers license

I can lift heavy items

I do have a criminal record

I can work over 8 hours

I can administer first aid

From the list below, what would be your most preferred work area?

Please select work areas you would also work, should your preferred location not be available. Press and hold CRTL on your keyboard to select more than one option.