Employment West Memphis Dispensary Employment Order Number First Name * Last Name * Contact Number * Email Address * Position(s) of Interest * Retail Dispensary Cultivation Processing Delivery Security Other Employment Interest: Full-Time Part-Time Temporary Shift Desired Day Swing Graveyard Rotating Weekends Only Are you able to perform the essential functions of the job you are applying for, with or without reasonable accommodation? * Yes No Prospective employees with West Memphis Dispensary will undergo a background check verifying they are at least 21 years of age and have no previous drug charges, and submit to fingerprinting. Can you meet all the above requirements for licensure for an state Marijuana Registered Agent card? * Yes No Date Available Highest Education Obtained * GED or Equivalent High School Some College College - Associates College - Bachelor of Arts College - Bachelor of Fine Arts College - Bachelor of Science College - Master of Arts College - Master of Fine Arts College - Master of Science College - Master of Business Administration College - Doctorate Medical Doctor Other College / University Message / Comments I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false statements reported on this application may be considered sufficient cause for dismissal. * Yes No
