Information

Full Name: Tull Olivia G Date: October 11, 2017

Last First M.I.
Address: 7878 Cedar Edge Road
Street Address Apartment/Unit #
Roanoke Virginia 24018
City State ZIP Code
Phone: (540) 728-1558 E-mail Address: ogtull54@gmail.com

Date Available: 10/12/2017 Social Security No.: 123-45-6789 Desired Salary: $

Position Applied for: Nurse Anesthetist

YES NO YES NO
Are you a citizen of the United States? X If no, are you authorized to work in the U.S.?
YES NO
Have you ever worked for this company? X If yes, when?
YES NO
Have you ever been convicted of a felony? X

If yes, explain:

Education
High School: Cave Spring High School Address: 3712 Chapparal Drive, Roanoke, VA, 24018
August YES NO
From: 2015 To: May 2019 Did you graduate? X Degree: Advanced Diploma

College: James Madison University Address: 800 S Main St, Harrisonburg, VA 22807
YES NO
From: To: Did you graduate? X Degree: Nursing, CRNA

Other: Address:
YES NO
From: To: Did you graduate? Degree:

References
Please list three professional references.

Full Name: Mary Hamilton Relationship: Head Swim Coach, Supervisor

Company: Spring Run Swim Club Phone: (540) 797-7666

Address:

Full Name: Kristen Yeatts Relationship: Manager at Elderberrys

Company: Elderberrys Phone: (540) 761-0763

Address:

Full Name: Lilly Judge Relationship: Youth Pastor

Company: St. John Lutheran Church Phone: (410) 980-3400

Address:
Previous Employment
Company: Elderberrys Phone: (540) 760-0600

Address: 3555 Electric Rd, Roanoke, VA 24018 Supervisor: Rebecca Mason

Job Title: General Employee Starting Salary: $7.50/hr. Ending Salary: $

Responsibilities: Making smoothies, making wraps, taking orders on register

August
From: 2016 To: Present Reason for Leaving: Currently Employed
YES NO
May we contact your previous supervisor for a reference? X
Phone:
(540) 774-
Company: Spring Run Swim Club 9952

Address: 6328 Ran Lynn Drive, Roanoke, VA 24018 Supervisor: Davis Perkins/Mary Hamilton
Lifeguard and Swim Team
Job Title: Instructor Starting Salary: $8/hr. Ending Salary: $

Responsibilities: Lifeguard, run swim team practice

From: June 2015 To: Present Reason for Leaving: Still Currently Employed
YES NO
May we contact your previous supervisor for a reference? X

Company: Phone: ()

Address: Supervisor:

Job Title: Starting Salary: $ Ending Salary: $

Responsibilities:

From: To: Reason for Leaving:

YES NO
May we contact your previous supervisor for a reference?

Military Service
Branch: From: To:

Rank at Discharge: Type of Discharge:

If other than honorable, explain:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.
Olivia Grace Tull
10/11/17