Choose "Yes", "No" or "Maybe" for the shifts that you can work, cannot work, or might be able to work or have limited availability to work, respectively. If "No" or "Maybe" is marked, please give a brief explanation why in the box below:
By submitting this application, I certify that all statements given on this application are correct, and realize that falsification or misrepresentation of this or another personal record may result in my discharge.