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Job Application
2050 Stemmons # 11037-4
PO Box 421128
Dallas,TX 75207
214-631-0001
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Instructions for filling out the job application.
1. Fill in All Personal Information Fields
2. Use the TAB or ENTER OR mouse to navigate from field to field.
3. When Complete Click on the Next Button
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Medical Records
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| Typhoid or Paratyphoid?:
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| Recurrent Infection of mouth, nose, ears, eyes?:
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| Back Trouble:
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| Heart Disease:
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| Epilepsy, fits, blackouts or fainting?:
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| Skin conditions e.g. dermatitis?:
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| Mental ill health or nervous disability:
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| Chest disease:
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| Digestive or bowel disorder:
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| Kidney or bladder disorder:
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| Diabetes:
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| Any other serious illness:
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| Are you receiving medical treatment?:
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| Do you wear glasses or contact lenses:
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| Do you wear glasses/contact lenses for close work:
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| Other illnesses or injuries relevant to your application:
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| Are you willing to be medically examined?:
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| How many days have you been absent in the last 2 years due to sickness?:
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| T-Shirt/Shirt Size:
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| Trouser Size Waist & Length:
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