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Detasseling Information Request Form
This Information Request is not an offer of employment. An offer of employment, if made at all, will be made at a later time.

We hire all of our employees from the , , Portage North, Portage Central, area(s). If you are not from the above area(s) you should not fill out this request form.

Name:
Address:
City:
  State:  MI   Zip: 
Age:
  Birthdate: 
Phone:
E-mail:
School:
Have You Detasseled Before:
If you Answered Yes Above, How Many Years?:




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