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%%full_name%% is applying for %%position%%
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Address: %%address%% %%apt%% %%city%%, %%state%% %%zipcode%%
Phone: %%phone_2%% |
email address: %%email_address%%
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Job preferences
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Schedule Preference: %%full-part-time%%
Full-Time Shift: %%fulltime_shift%% Part-Time Shift: %%partime_shift%%
Overtime? %%overtime%% Desired Salary: %%desired_salary%%
Worked for Seasons? %%worked_for_seasons%% Date Available: %%date_available%%
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Legal Information
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U.S. Citizen: %%us_citizen%% Authorized to work in U.S.: %%us_authorized%%
Felony Conviction: %%felony_conviction%%
Felony Explanation: %%felony_explanation%%
State/Country Residences: %%residence_location_1%% %%residence_location_2%% %%residence_location_3%% %%residence_location_4%% %%residence_location_5%% %%residence_location_6%%
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Education Information
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Highest Education Achieved: %%education_selection%%
High School: %%high_school%% %%from_high_school%% – %%to_high_school%%
College: %%college_1%% %%from_college_1%% – %%to_college_1%%
%%college_1_degree%%
Graduate College: %%college_2%% %%from_college_2%% – %%to_college_2%%
%%college_2_degree%%
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Work History
%%company_1%%
%%job_title_1%%
%%job_description%%
Salary: %%job_salary_1%%
Supervisor: %%job_supervisor_1%% Contact Employer? %%contact_employer_1%%
Address: %%co1_address_2%% Phone: %%company_1_phone%%
%%company_2%% %%from_job_2%%-%%to_job_2%%
%%job_title_2%%
%%job_description_2%%
Salary: %%job_salary_2%%
Supervisor: %%job_supervisor_2%% Contact Employer? %%contact_employer_2%%
Address: %%co2_address%% Phone: %%company_2_phone%%
%%company_3%% %%from_job_3%%-%%to_job_3%%
%%job_title_3%%
%%job_description_3%%
Salary: %%job_salary_3%%
Supervisor: %%job_supervisor_2%% Contact Employer? %%contact_employer_3%%
Address: %%co1_address_3%% Phone: %%company_3_phone%%
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” send_copy_to_sender=”on” sender_email_field=”email_address” reply_from_email=”custom” reply_custom_from_email=”office@seasonshealthgroup.com” reply_to_name=”Seasons Health Group” reply_to_email=”office@seasonshealthgroup.com” reply_email_title=”New Employment Application” reply_email_template=”Dear %%full_name%%,
Thank you for submitting your application for employment here at Seasons Health and Rehab, and appreciate your interest. We look forward to reviewing your application and hope to find a fit for you.
If you have any questions regarding your application, please reach out to us at office@seasonshealthgroup.com or call 435 628 1601.
Thanks again.
Best,
Seasons Health Group” whole_form_margin=”||||false|false” multistep_enabled=”on” multistep_progress_bar_active_color=”#7CDA24″ multistep_progress_bar_margin=”||42px||false|false” use_simple_captcha=”on” simple_captcha_required_text=”This is also required.” _builder_version=”4.24.0″ _module_preset=”default” _unique_id=”178030a1-d3d5-4bf5-9f53-9102f3d8d55d” form_field_background_color=”#f4f4f4″ form_field_text_color=”#515151″ form_title_font=”Montserrat|800||on|||||” form_title_text_color=”#FFFFFF” label_text_font=”Montserrat|||on|||||” placeholder_text_text_color=”#848484″ progress_bar_step_number_active_font=”|700|||||||” progress_bar_step_number_active_font_size=”16px” form_field_font=”Montserrat|||on|||||” custom_button=”on” button_text_color=”#FFFFFF” button_bg_color=”#7CDA24″ button_font=”Montserrat||||||||” custom_previous_step_button=”on” previous_step_button_text_size=”17px” previous_step_button_text_color=”#FFFFFF” previous_step_button_bg_color=”#e0625c” previous_step_button_border_radius=”20px” previous_step_button_letter_spacing=”3px” previous_step_button_font=”|||on|||||” previous_step_button_icon=”<||divi||400″ previous_step_button_icon_color=”#FFFFFF” previous_step_button_icon_placement=”left” previous_step_button_custom_padding=”|31px||31px|false|true” custom_next_step_button=”on” next_step_button_text_size=”17px” next_step_button_text_color=”#FFFFFF” next_step_button_bg_color=”#7CDA24″ next_step_button_border_radius=”20px” next_step_button_letter_spacing=”2px” next_step_button_font=”|||on|||||” next_step_button_icon=”=||divi||400″ next_step_button_icon_color=”#FFFFFF” next_step_button_custom_padding=”|31px||31px|false|true” custom_css_free_form=”.form-title {|| background-color: rgb(27,27,76);|| padding: 50px 50px 30px 20px;|| font-size: 40px||}” border_width_all=”1px” border_color_all=”#848484″ border_color_all_form=”#000000″ global_colors_info=”{}”][de_fb_form_field field_title=”Step 1″ admin_title=”Step 1″ field_id=”step_1″ field_type=”step” required_mark=”on” enable_placeholder=”off” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”0″ form_class=”de_fb_form_0″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Contact Details” admin_title=”Contact Details Header” field_id=”contact_header” field_type=”html_content” html_content_editor=”
General Details
” _builder_version=”4.23.4″ _module_preset=”default” content_text_font_size=”12px” content_text_line_height=”1.4em” header_2_font=”|||on|||||” header_2_text_color=”#FFFFFF” header_2_letter_spacing=”3px” custom_css_free_form=”h2 {background-color: #7cda24; padding: 8px;||}” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Full Name” admin_title=”full_name” field_id=”full_name” required_mark=”on” field_grid_column=”et_pb_column_1_3″ field_placeholder=”Full Name” _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Phone” admin_title=”Phone” field_id=”phone_2″ max_length=”10″ allowed_symbols=”numbers” required_mark=”on” field_grid_column=”et_pb_column_1_3″ field_placeholder=”Phone Number” _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Address” admin_title=”Address” field_id=”address” required_mark=”on” field_grid_column=”et_pb_column_3_4″ field_placeholder=”Your Address” _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Apt #” admin_title=”Apt” field_id=”apt” max_length=”10″ allowed_symbols=”numbers” field_grid_column=”et_pb_column_1_4″ field_placeholder=”Apartment #” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”City” admin_title=”City” field_id=”city” required_mark=”on” field_grid_column=”et_pb_column_1_3″ field_placeholder=”City” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”State” admin_title=”State” field_id=”state” required_mark=”on” field_grid_column=”et_pb_column_1_4″ field_placeholder=”State” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”zip code” admin_title=”zip code” field_id=”zipcode” allowed_symbols=”numbers” required_mark=”on” field_grid_column=”et_pb_column_1_4″ field_placeholder=”Zip Code” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Email Address” admin_title=”Email Address” field_id=”email_address” field_type=”email” required_mark=”on” field_grid_column=”et_pb_column_1_2″ field_placeholder=”Email Address” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Step 2″ admin_title=”Step 2″ field_id=”step_2″ field_type=”step” required_mark=”on” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”1″ form_class=”de_fb_form_0″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Job Info” admin_title=”Job Info” field_id=”job_info” field_type=”html_content” html_content_editor=”
JOB INFO & Availability
” _builder_version=”4.23.4″ _module_preset=”default” content_text_font_size=”12px” content_text_line_height=”1.4em” header_2_font=”|||on|||||” header_2_text_color=”#FFFFFF” header_2_letter_spacing=”3px” custom_css_free_form=”h2 {background-color: #7cda24; padding: 8px;||}” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”section 1 divider” admin_title=”section 1 divider” field_id=”section_1_divider” field_type=”html_content” _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” custom_css_main_element=”border-bottom: 1px solid rgb(60,221,8);||margin-bottom: 10px;” border_color_all=”RGBA(255,255,255,0)” border_color_bottom=”#7CDA24″ global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Position” admin_title=”positiion” field_id=”position” field_type=”select” select_placeholder=”on” select_placeholder_text=”Which position are you applying for ?” select_options=”%91{%22value%22:%22Registered Nurse (RN)%22,%22checked%22:0,%22dragID%22:-1},{%22dragID%22:0,%22value%22:%22Licensed Pratical Nurse (LPN)%22,%22checked%22:0},{%22dragID%22:1,%22value%22:%22Certified Nurses Assistant (CNA)%22,%22checked%22:0},{%22dragID%22:2,%22value%22:%22Dietrary/Kitchen%22,%22checked%22:0},{%22dragID%22:3,%22value%22:%22Housecleaning%22,%22checked%22:0},{%22dragID%22:4,%22value%22:%22Other%22,%22checked%22:0}%93″ required_mark=”on” field_grid_column=”et_pb_column_3_4″ field_placeholder=”Full Name” _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”PREFERRED SHIFT” admin_title=”Working Preferences” field_id=”full-part-time” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22FULL-TIME%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22PART-TIME%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”on” field_grid_column=”et_pb_column_2_3″ field_label_position=”top” checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”||||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”FULL-TIME” admin_title=”Full Time” field_id=”fulltime_shift” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22DAY%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22AFTERNOON%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22GRAVEYARD%22,%22checked%22:0,%22dragID%22:1}%93″ field_grid_column=”et_pb_column_1_2″ field_label_position=”top” checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” enable_placeholder=”off” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22full-part-time%22,%22condition%22:%22is%22,%22value%22:%22FULL-TIME%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”12px||||false|false” custom_css_main_element=”border: 1px solid #888;||padding: 6px;” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”PART-TIME” admin_title=”Part Time” field_id=”partime_shift” field_type=”checkbox” checkbox_options=”%91{%22value%22:%22DAY%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22AFTERNOON%22,%22checked%22:0,%22dragID%22:0},{%22value%22:%22GRAVEYARD%22,%22checked%22:0,%22dragID%22:1}%93″ field_grid_column=”et_pb_column_1_2″ field_label_position=”top” checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” enable_placeholder=”off” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22full-part-time%22,%22condition%22:%22is%22,%22value%22:%22PART-TIME%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”12px||||false|false” custom_css_main_element=”border: 1px solid #888;||padding: 6px;” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Desired Salary” admin_title=”Desired Salary” field_id=”desired_salary” field_grid_column=”et_pb_column_1_4″ field_placeholder=”Desired Annual Salary” _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Date Available” admin_title=”Date Available” field_id=”date_available” field_type=”datepicker” required_mark=”on” date_format=”mm-dd-yy” field_grid_column=”et_pb_column_1_2″ field_placeholder=”Available Start Date (mm-dd-yyyy)” _builder_version=”4.23.4″ _module_preset=”default” custom_padding=”|16px|||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”worked for Seasons” admin_title=”Worked for Seasons” field_id=”worked_for_seasons” field_type=”radio” checkbox_options=”%91{%22value%22:%22Have you ever worked for Seasons or Porter’s Nursing Home?%22,%22checked%22:0,%22dragID%22:-1}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22dragID%22:0,%22value%22:%22No%22,%22checked%22:0}%93″ field_grid_column=”et_pb_column_3_4″ checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” enable_placeholder=”off” description_text=”on” description_text_text=”Have you ever worked for Seasons or Porter’s Care Center before?” _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”||||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”overtime” admin_title=”Overtime” field_id=”overtime” field_type=”radio” checkbox_options=”%91{%22value%22:%22Are you willing to work overtime as necessary?%22,%22checked%22:0,%22dragID%22:-1}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22dragID%22:0,%22value%22:%22No%22,%22checked%22:0}%93″ field_grid_column=”et_pb_column_3_4″ checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” radio_checkbox_margin=”||0px||false|false” enable_placeholder=”off” description_text=”on” description_text_text=”Are you willing to work overtime as needed?” label_padding=”|||0px|false|false” _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”||||false|false” global_colors_info=”{}” form_step=”2″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Step 3″ admin_title=”Step 3″ field_id=”step_3_2″ field_type=”step” checkbox_options=”%91{%22value%22:%22Are you willing to work overtime as necessary?%22,%22checked%22:0,%22dragID%22:-1}%93″ field_grid_column=”et_pb_column_3_4″ radio_checkbox_padding=”|15px|||false|false” radio_checkbox_margin=”||0px||false|false” enable_placeholder=”off” label_padding=”|||0px|false|false” _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”||||false|false” global_colors_info=”{}” form_step=”2″ form_class=”de_fb_form_0″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Legal Status” admin_title=”Legal Status Header” field_id=”legal_status” field_type=”html_content” html_content_editor=”
LEGAL STATUS
” _builder_version=”4.23.4″ _module_preset=”default” content_text_font_size=”12px” content_text_line_height=”1.4em” header_2_font=”|||on|||||” header_2_text_color=”#FFFFFF” header_2_letter_spacing=”3px” custom_css_free_form=”h2 {background-color: #7cda24; padding: 8px;||}” global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”section 2 divider” admin_title=”section 2 divider” field_id=”section_2_divider” field_type=”html_content” _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” custom_css_main_element=”border-bottom: 1px solid rgb(60,221,8);||margin-bottom: 10px;” border_color_all=”RGBA(255,255,255,0)” border_color_bottom=”#7CDA24″ global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Are you a US Citizen?” admin_title=”US Citizen” field_id=”us_citizen” field_type=”radio” checkbox_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22NO%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”on” field_grid_column=”et_pb_column_1_3″ field_label_position=”top” checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” enable_placeholder=”off” _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”||||false|false” global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Are you authorized to work in the US?” admin_title=”US authorized” field_id=”us_authorized” field_type=”radio” checkbox_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22dragID%22:0,%22value%22:%22No%22,%22checked%22:0}%93″ required_mark=”on” field_grid_column=”et_pb_column_1_2″ field_label_position=”top” checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” enable_placeholder=”off” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22us_citizen%22,%22condition%22:%22is%22,%22value%22:%22NO%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”||||false|false” global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Citizen Disclaimer” admin_title=”Citizen Disclaimer” field_id=”citizen_disclaimer” field_type=”html_content” html_content_editor=”
Federal laws require that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with such laws, Seasons Health and Rehabilitation and its subsidiaries will verify the status of every individual offered employment with the company. In this connection, all offers of employment are subject to verification of the applicant’s identity and employment authorization, and it will be necessary for you to submit such documents as are required by law to verify our identification and employment authorization upon employment.
” _builder_version=”4.23.4″ _module_preset=”default” content_text_font_size=”12px” content_text_line_height=”1.4em” global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Have you ever been convicted of a felony?” admin_title=”Felony Conviction” field_id=”felony_conviction” field_type=”radio” checkbox_options=”%91{%22value%22:%22Have you ever been convicted of a felony?%22,%22checked%22:0,%22dragID%22:-1}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”on” field_grid_column=”et_pb_column_1_2″ field_label_position=”top” checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” radio_checkbox_padding=”|15px|||false|false” enable_placeholder=”off” _builder_version=”4.23.4″ _module_preset=”default” label_text_font=”|700|||||||” label_text_text_color=”#000000″ custom_margin=”||||false|false” global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Felony Explanation” admin_title=”Felony Explanation” field_id=”felony_explanation” field_type=”text” textarea_limit=”300″ field_placeholder=”YES – PLEASE STATE NATURE OF OFFENSE, WHEN, WHERE AND DISPOSITION” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22felony_conviction%22,%22condition%22:%22is%22,%22value%22:%22Yes%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Felony Disclaimer” admin_title=”Felony Disclaimer” field_id=”felony_disclaimer” field_type=”html_content” html_content_editor=”
*A conviction record will not necessarily disqualify you for employment. This information is used only for job-related purposes and only to the extent permitted by applicable law.
” _builder_version=”4.23.4″ _module_preset=”default” content_text_font_size=”12px” content_text_line_height=”1.4em” global_colors_info=”{}” form_step=”3″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Residence Instructions” admin_title=”Residence Instructions” field_id=”Residence_Instructions” field_type=”html_content” html_content_editor=”
For security purposes, list the states and countries of residence for the past seven (7) years:
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EDUCATION
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_builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”4″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Name of High School” admin_title=”High School” field_id=”high_school” field_grid_column=”et_pb_column_1_3″ field_placeholder=”Where did you go to High School?” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22education_selection%22,%22condition%22:%22is%22,%22value%22:%22Did not graduate High School%22},{%22field%22:%22education_selection%22,%22condition%22:%22is%22,%22value%22:%22High School GED%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”4″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”From High School” admin_title=”From High School” field_id=”from_high_school” allowed_symbols=”numbers” pattern_message=”Please enter the year you started” field_grid_column=”et_pb_column_1_4″ field_placeholder=”From (Year)” conditional_logic=”on” 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field_title=”To College 1″ admin_title=”To College 1″ field_id=”to_college_1″ allowed_symbols=”numbers” pattern_message=”Please enter the year you finished” field_grid_column=”et_pb_column_1_4″ field_placeholder=”To (Year)” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22education_selection%22,%22condition%22:%22is%22,%22value%22:%22Some College%22},{%22field%22:%22education_selection%22,%22condition%22:%22is%22,%22value%22:%22Bachelors Degree%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”4″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”College 1 Degree” admin_title=”College 1 Degree” field_id=”college_1_degree” field_grid_column=”et_pb_column_1_3″ field_placeholder=”Degree, field of study” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22education_selection%22,%22condition%22:%22is%22,%22value%22:%22Bachelors Degree%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” 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conditional_logic_rules=”%91{%22field%22:%22education_selection%22,%22condition%22:%22is%22,%22value%22:%22Graduate Degree%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” custom_css_main_element=”border-bottom: 1px solid rgb(60,221,8);||margin-bottom: 10px;” border_color_all=”RGBA(255,255,255,0)” border_color_bottom=”#7CDA24″ global_colors_info=”{}” form_step=”4″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Step 5″ admin_title=”Step 5″ field_id=”step_5″ field_type=”step” field_grid_column=”et_pb_column_1_3″ field_placeholder=”Degree, field of study” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22education_selection%22,%22condition%22:%22is%22,%22value%22:%22Graduate Degree%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”4″ form_class=”de_fb_form_0″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”WORK HISTORY Header” admin_title=”Work 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WORK HISTORY
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_builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Job Description 2″ admin_title=”Job Description 2″ field_id=”job_description_2″ field_type=”text” textarea_rows=”10″ field_placeholder=”Job Descrption, Duties, & achievements” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Add Employer 2″ admin_title=”Add Employer 2″ field_id=”add_employer_2_2″ field_type=”checkbox” checkbox_options=”%91{%22value%22:%22Add an Employer%22,%22checked%22:0,%22dragID%22:-1}%93″ field_grid_column=”et_pb_column_1_4″ radio_checkbox_field_style=”button” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” custom_radio_checkbox_button=”on” radio_checkbox_button_text_size=”12px” radio_checkbox_button_text_color=”#FFFFFF” radio_checkbox_button_bg_color=”#0C71C3″ radio_checkbox_button_icon=”P||divi||400″ custom_radio_checkbox_button_active=”on” radio_checkbox_button_active_text_size=”12px” radio_checkbox_button_active_text_color=”#FFFFFF” radio_checkbox_button_active_bg_color=”#e8e8e8″ global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”job Divider” admin_title=”Job Divider” field_id=”job_divider_1″ field_type=”html_content” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” custom_margin=”||||false|false” custom_css_main_element=”border-bottom: 1px solid rgb(60,221,8);||margin-bottom: 10px;” border_color_all=”RGBA(255,255,255,0)” border_color_bottom=”#7CDA24″ global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Job Title 3″ admin_title=”Job Title 3″ field_id=”job_title_3″ field_grid_column=”et_pb_column_1_3″ field_placeholder=”Job Title” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”From Job 3″ admin_title=”From Job 3″ field_id=”from_job_3″ allowed_symbols=”numbers” pattern_message=”Please enter the year you started” field_grid_column=”et_pb_column_1_4″ field_placeholder=”From (Year)” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”To Job 3″ admin_title=”To Job 3″ field_id=”to_job_3″ allowed_symbols=”numbers” pattern_message=”Please enter the year you finished” field_grid_column=”et_pb_column_1_4″ field_placeholder=”To (Year)” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Company 3″ admin_title=”Company 3″ field_id=”company_3″ field_grid_column=”et_pb_column_1_3″ field_placeholder=”Name of Company/Organization” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”company 3 phone” admin_title=”Company 3 Phone” field_id=”company_3_phone” allowed_symbols=”numbers” pattern_message=”Please enter numbers only.” field_grid_column=”et_pb_column_1_3″ field_placeholder=”Phone” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Company 3 Address” admin_title=”Company 3 Address” field_id=”co3_address” field_grid_column=”et_pb_column_3_4″ field_placeholder=”Full Address (street, city, state, zip)” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Job 3 SUPERVISOR” admin_title=”Job Supervisor 3″ field_id=”job_supervisor_3″ field_grid_column=”et_pb_column_1_3″ field_placeholder=”SUPERVISOR” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Job 3 Salary” admin_title=”Job Salary 3″ field_id=”job_salary_3″ field_grid_column=”et_pb_column_1_3″ field_placeholder=”ENDING SALARY” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”contact employer 3″ admin_title=”Contact Employer 3″ field_id=”contact_employer_3″ field_type=”radio” checkbox_options=”%91{%22value%22:%22%22,%22checked%22:0,%22dragID%22:-1}%93″ radio_options=”%91{%22value%22:%22Yes%22,%22checked%22:0,%22dragID%22:-1},{%22value%22:%22No%22,%22checked%22:0,%22dragID%22:0}%93″ required_mark=”on” field_grid_column=”et_pb_column_1_3″ checkbox_radio_inline=”on” checkbox_radio_inline_full=”on” description_text=”on” description_text_text=”May we contact your previous employer as a reference?” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][de_fb_form_field field_title=”Job Description 3″ admin_title=”Job Description 3″ field_id=”job_description_3″ field_type=”text” textarea_rows=”10″ field_placeholder=”Job Descrption, Duties, & achievements” conditional_logic=”on” conditional_logic_rules=”%91{%22field%22:%22add_employer_2_2%22,%22condition%22:%22is%22,%22value%22:%22Add an Employer%22}%93″ _builder_version=”4.23.4″ _module_preset=”default” global_colors_info=”{}” form_step=”5″ current_step=”1″][/de_fb_form_field][/de_fb_form]
