Legal First Name *

Legal Last Name *

Email *

Phone *

Street Address *

City *

State *

Zip *

18 Years Old or Older? * Yes No

Highest Level of Education Completed * High School or Equivalent Technical/Associates Some College Other

Preferred Method of Communication (Check All That Apply) * PhoneEmailText

Shift Preference (Check All That Apply) * Less Than 4 Hours8 Hours10 Hours12 HoursPart-TimeOther

Schedule (Check All That Apply) * MorningsDaysEveningsNightsWeekends

Facility Preference * 3030 Airport Rd, La Crosse 546032009 West Ave S, La Crosse, 54601

Are you a US Citizen or have documents that legally allow you to work in the US? * Yes No

What type of positions are you interested in?

What are you looking for in your next employment opportunity?

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