Pierce County Fair

First Name

Use the Name on your Social Security Card

Last Name

Email Address

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Personal Information

Address Line 1

This is where your paycheck will be mailed to

Address Line 2

City

State

Postal Code

Phone Number

Can we text you at this number?

Yes
No

Yes

Date Of Birth

Emergency Contact Person (Full Name)

Emergency Contact Phone

Do you live in Washington State? This fair is in Graham, Washington

Yes
No

Yes

Click here if you live in Wisconsin

Are you legally eligible for employment in the United States?

Yes
No

Yes

Yes
No

Yes
No

Yes
No

Yes
No

Previous Employer Name

Phone

Previous Employer Name

Phone

Reference Name (Full Name)

Phone

Reference Name (Full Name)

Phone

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