Employment Aplique Aqui Employment Form Today's Date Last Name First Name Middle Initial Address City State Zip Home Phone, Cell or Pager Email Are you legally eligible to work in the United States? Yes No Have you worked for us before? Yes No When? Date you will be available to start work Have you worked in maintenance Yes No Where? Have you ever been convicted of a felony Yes No In what state? Explain Are you 18 years of age or older? Yes No Availability Full time (7-8 hours days) Part time (6 or less hours a day) Shift Desired Days Evenings Over Nights What days are you unable to work? What languages do you speak? Indicate the fluency level May we contact your current employer? Yes No Company Name Address Phone Dates of Employment - From (MM/YY) Dates of Employment - To (MM/YY) Name of Supervisor Job Title Responsibilities Reason For Leaving Starting Salary Ending Salary I have read the statement above and agree Yes No Send
