It is our policy to provide equal employment opportunities to all qualified persons without regard to race, color, religion, sex, national origin, age, disability or any other characteristic protected by state or federal law.
Name CollinsFalanda JeanPrevious Name(s) N/A
Present Address 200, cervantes village , NM 88001
Permanent Address 200, cervantes village, NM 88001
Phone Number 575.805.8352 Alternative or Work Phone 575.652.3312 Have you ever been employed by us before? Yes No Are you 18 years or older? Yes No Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? Yes No Have you ever been convicted of any crime, including misdemeanors and felonies? Yes No
If yes, please state the nature of the offense and the date of the conviction.
NOTE:Answering “yes” to the above question does not constitute an automatic bar from employment. Factors such as the date of the conviction, seriousness and nature of the conviction, and position applied for will be considered.
Position s Date you can start 04/20/2013 Salary desired 9.50hr Are you employed now? Yes No If so, may we contact your present employer? Yes No Have you applied to this company within the past 12 months?
Yes No When? Where?
How did you hear about our company? internet
Employment History (Please list all of your employers for the last five years, beginning with the last one first)
From 04.03 To 11.04 Employer Wal-mart Supervisor Debbie Employer Address 8401 anderson blvd Telephone Number 817.276.9021 Position customer service Wage/Salary 8.40hr
Reason for Leaving Family Issue
From 06.06 To 10.09 Employer Motorola Supervisor Mrs.Jessica Employer Address Telephone Number 817.847.9256 Position merchandiser Wage/Salary 9.00hr
Reason for Leaving temp work
From 03.11 To 06.12 Employer K-Mart Supervisor Mr. Worton Employer Address Baatan Memorial Telephone Number 575.522.7135 Position lead merchandiser Wage/Salary 7.75hr
Reason for Leaving too stressful
| |Name & Location |Number of years completed |Did you graduate? |Subject(s) studied & Degree(s) | | | | | |received | |High School |Keller High School |2 | Yes No |GED | |College |NMSU |2 | Yes No |Administrative Assistant | |Other |N/A | | Yes No | |
References (Please give the names of three persons not related to you, whom you have known at least one year.)
|Name |Address |Telephone |Relationship to You | |Linda Skalic |2800 Sonoma Ranch Blvd |575.528.7000 |Professor/ Advisor | |Rick Martinez |3200 Del Rey #15 |575.644.2010 |Friend | |Anita Aguirre |3200 Del Rey #168 |575.993.3322 | Collegue |
Please list any additional information you would like us to consider (i.e. specialized skills, certifications, etc.): N/A
Pre-Placement Physical Assessment: I understand that A-1...