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Check one White Hispanic or Latino Black or African American Asian Native Hawaiian or other Pacific Islander American Indian or Alaskan Native Two or more races Social Security No. Male Female Office Instructions 1. I understand that any misrepresentation falsification or material omission of information on this application may result in my failure to receive an offer or if I am hired in my termination from employment. File this form in a separate confidential file. 2. Use this information...
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