Employment Form (English) Application for Employment Position You are Applying For (Posición para la que solicita) Day Shift Y/N(Turno de dia) Yes No Night Shift Y/N(Turno nocturne) Yes No Desired Salary $(Salario deseado) Are you Bilingual ?Eres bilingue ? Yes No IF yes What Languages do you speak?Si si, que idiomas hablas?Language 1 Language 2 PERSONAL INFORMATION (INFORMACION PERSONAL) First Name(Nombre de pila) Middle NameSegundo nombre Last NameApellido Address City Zip How Long Have you lived at this address ? . Cell Phone # Home Phone # Email Are you a US CitizenEres un ciudadano de los Estados Unidos Yes No Do you have a Felony Arrest ?¿Tienes un arresto por delito grave Yes No Can you pass a Drug Test Today ? (¿Puede aprobar un examen de drogas Yes No Social Security Number Have you or an Acquaintance worked for these companies before? Yes No Drivers Lic # State issued Are you Able to Drive at Night ? Yes No Are you Willing to Drive on Freeways Yes No Do you have a phone that has GPS and can you use it? Yes No Do you have any Appointments or vacation planed in the next 60 day? ¿Tiene alguna cita o vacacions planeadas en los próximos 60 días? Yes No Date PERSONAL INFORMATION 2 (INFORMACION PERSONAL 2) Do you have the ability to lift 25-30 pounds ? ¿Tiene la capacidad de levantar 25-30 libras? Yes No If No please explain Do you have Allergies to any Animals ? ¿Tiene alergia a algún animal? Yes No If Yes what animals ? Are you able to use a Ladder 8-10 Feet high ? Yes No If No Please Describe how high you can go on a Iadder Day Shift is Monday-Friday and Every other Saturday are you able to work these days ? El turno de un día es de lunes a viernes y cada otro sábado puedes trabajar estos días?) Yes No We start at 8:30AM At the Office and Work until completed occasionally after 6 pm, Can you work these hours ? Yes No I Agree and Stating everything stated above is truthful I Agree EMPLOYMENT HISTORY (HISTORIA DEL EMPLEO) Last EmployerÚltimo empleador Dates Employed Fechas de empleo From To Work Phone Number Contact Name (Your Supervisor) Suporvisors Direct Phone # Ext. Cell Work Address City Zip Your Start Rate $Su tasa de inicio (Hourly) (%) ( Salary) Your Job Title Number of People you SupervisedNúmero de personas que supervisó Were You Fired Yes No If Yes Why? Did You Quit the Position? Yes No If Yes Why? Did you Give Two Week's Notice? Yes No If no Why ? EMPLOYMENT HISTORY 2 (HISTORIA DEL EMPLEO 2) Last EmployerÚltimo empleador Dates Employed Fechas de empleo From To Work Phone Number Contact Name (Your Supervisor) Suporvisors Direct Phone # Ext. Cell Work Address City Zip Your Start Rate $Su tasa de inicio (Hourly) (%) ( Salary) Your Job Title Number of People you SupervisedNúmero de personas que supervisó Were You Fired Yes No If Yes Why? Did You Quit the Position? Yes No If Yes Why? Did you Give Two Week's Notice? Yes No If no Why ? PERSONAL REFERENCE (REFERENCIAS PERSONALES) (1) Name Relationship Company Phone Number (2) Name Relationship Company Phone Number I Agree and Stating everything stated above is truthful I Agree Submit