Message from the President
Do you want to Work With the Best?
BonaDent Dental Laboratories
is an Equal Opportunity Employer

BonaDent Dental Laboratories is an "at-will" employer and reserves the right to terminate employment with or without cause and without prior notice except as limited by law.

Experienced Dental Technicians
Your Experience
Or

Applicant Characteristic Form

The employment position for which you are applying has been made available with financial assistance from the Town of Seneca Falls using Federal Community Development Block Grant Funding. As a result, the employer is required to obtain the following information:

Instructions:

Determine your family size by counting yourself and each family member who currently resides with you within the same housing unit. A family member is a person who is related to you by birth, marriage or adoption. Input the appropriate family size below. Next, total the income from all sources received during the last calendar year (January-December) by yourself and each member of your family who current resides with you. Income includes wages, salaries, tips, business income, interest, dividends, the taxable portion of pensions and annuities, IRA distributions, rents, royalties, partnerships, unemployment compensation, and social security; less alimony paid and unreimbursed employee business expenses calculated with IRS Form 2106. Compare this total to the figure listed for the family size you indicated and select the appropriate income range next to your family size.

Family Size Below 30% Between 30%
and 50%
Between 50%
and 80%
Over 80%
1 $11,649 $11,650 - $19,399 $19,400 - $30,999 $31,000
2 $13,299 $13,300 - $22,149 $22,150 - $35,339 $35,400
3 $14,949 $14,950 - $24,899 $24,900 - $39,849 $39,850
4 $16,599 $16,600 - $27,649 $27,650 - $44,249 $44,250
5 $17,949 $17,950 - $29,899 $29,900 - $47,799 $47,800
6 $19,299 $19,300 - $32,099 $32,100 - $51,349 $51,350
7 $20,599 $20,600 - $34,299 $34,300 - $54,899 $54,900
8 $21,949 $21,950 - $36,499 $36,500 - $58,449 $58,450

Ethnicity
** Hispanic – HUD has designated Hispanic as an ethnic group. A person should be identified as both a member of a racial group and an ethnic group when this ethnic group is selected

The information provided herein will be confidential and will only be used to provide statistical data required under the Community Development Block Grant program. It is subject to verification pursuant to the rules and regulations of the New York State Office of Community Renewal and the U.S. Department of Housing and Urban Development.