Northern WI_Employment Application
Thank you for your interest in walking to protect the sanctity of human life and the most vulnerable among us - *babies*! Please complete the below employment application by answering each question to the best of your knowledge. If a required field doesn't apply to you, type "N/A" in the text box or select today's date.
Email *
Legal First Name *
Legal Last Name *
Middle Initial
Today's Date *
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Best Contact Phone Number *
Home Street Address *
Apartment / Unit #
City *
State *
Zip Code *
Date Available *
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Position Applied For *
Are you a citizen of the United States *
If NO, are you authorized to work in the U.S.? *
Have you ever worked for Susan B Anthony Pro-Life America, Susan B Anthony List, or any other affiliates? *
If YES, enter the name of your previous manager and the city and state you worked in. If NO, type "N/A". *
Have you ever been convicted of a felony? *
If YES, explain. If NO, type "N/A". *
Did you graduate high school? *
Enter the name and address of the high school you attended / graduated. *
Did you attend or graduate college? *
If YES, enter the name and address of the college you attended. If NO, type "N/A". *
If YES, enter the degree you graduated with or are pursuing. If NO, type "N/A". *
Do you have any additional educational history you would like to share? If YES, enter details below. If NO, type "N/A". *
#1 - Personal Reference Full Name 
(A personal reference is typically someone who is not related to you that can attest to your character and work ethic. Think about people in your community - school, church, past employment, sports, friends, etc.)
 *
#1 - Personal Reference Relationship to you. *
#1 - Personal Reference Phone Number *
#2 - Personal Reference Full Name *
#2 - Personal Reference Relationship to you. *
#2 - Personal Reference Phone Number *
#3 - Personal Reference Full Name *
#3 - Personal Reference Relationship to you *
#3 - Personal Reference Phone Number *
#1 - Previous Employment: Company Name *
#1 - Previous Employment: Company Address *
#1 - Previous Employment: Company Phone Number *
#1 - Previous Employment: Supervisor Name *
#1 - Previous Employment: Job Title and Description of Responsibilities *
#1 - Previous Employment: Start Date *
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#1 - Previous Employment: End Date *
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#1 - Previous Employment: Reason for Leaving *
#1 - Previous Employment: May we contact your previous employer? *
#2 - Previous Employment: Company Name *
#2 - Previous Employment: Company Address *
#2 - Previous Employment: Company Phone Number *
#2 - Previous Employment: Supervisor Name *
#2 - Previous Employment: Job Title and Description of Responsibilities *
#2 - Previous Employment: Start Date *
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#2 - Previous Employment: End Date *
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#2 - Previous Employment: Reason for Leaving *
#2 - Previous Employment: May we contact your previous employer? *
#3 - Previous Employment: Company Name *
#3 - Previous Employment: Company Address *
#3 - Previous Employment: Company Phone Number *
#3 - Previous Employment: Job Title and Description of Responsibilities *
#3 - Previous Employment: Start Date *
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#3 - Previous Employment: End Date *
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#3 - Previous Employment: May we contact your previous employer? *
Did you serve in the military? *
If YES, what branch did you serve in? If NO, type "N/A". *
Start Date of Service
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End Date of Service
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Rank at time of discharge
If other than honorable, explain.
How did you hear about this job opportunity with Susan B Anthony Pro-Life America? *
Do you think there should be reasonable restrictions on abortion? *
Do you think late-term or post-birth abortion should be legal? *
Why do you want to work with Susan B Anthony Pro-Life America? *
Provide details of an experience when you had to diffuse an angry customer and how you handled the situation. *
By typing my name below, I certify that my answers are true and correct to the best of  knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
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