NOTE: It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based
on race, age, color, sex, religion, national origin, or other protected classification. Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodations during the application
and/or interview process should notify a representative of the Human Resources Department.

First Name: Middle Name: Last Name:

Street Address: City:

CHOOSE A State or Providence

State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ***Canadian Providences*** Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Novia Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory

Home Telephone: Work Telephone:

Date of birth: Social Security Number:

Are You over 18 years old? yes no

Are You authorized to work in the U.S. on an unrestricted basis? yes no

Position Applied For:

How did you learn of this opening? Newspaper Telephony Magazine Website RJE Employee Other

Have you ever worked for RJE Telecom before? yes no

Are there any hours, shifts, or days you cannot or will not work?

Shift Preferred: I will work Part-time Full-time

Are you willing to work overtime, if required? yes no

Have you ever been convicted of a felony?

(Conviction will not necessarily disqualify an applicant for employment) yes no

If Yes Please Describe Conditions:

EDUCATION

Name and Location of:

High School: Major: Degree:

College/University: Major: Degree:

College/University: Major: Degree:

Other Training/Education: Major: Degree:

Summarize any special training, skills, lecenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying for.

Salary Desired: When can you start?

WORK HISTORY

May we contact your present employer? yes no

Most recent employer:

Address: Telephone:

Start date: End date:

Starting salary: Final Salary:

Starting position: Position on leaving:

Description of duties:

Reason for leaving:

Previous employer:

Address: Telephone:

Start date: End date:

Starting salary: Final Salary:

Starting position: Position on leaving:

Description of duties:

Reason for leaving: