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  JobTitle  
  First Name:*  
  Last Name:*  
  Address:  
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  Phone2:      
  Email*  
  Do you possess a valid Michigan Driver's License?  
  Types of positions you will accept:   Regular Temporary Seasonal
  Types of work you will accept:   Full Time Part Time Per Diem
  Shifts you will accept:   Day Evening Night
  Rotating Weekends On Call
  Special Skills (bilingual ability, etc.):  
  If you possess a college degree, indicate it here:  
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