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WORK WITH US
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Full name
*
puede semanal completo
Birthdate
*
Address
*
Email
*
Phone number
*
Languages spoken
Spanish
English
French
Japanese
Chinese
Italian
Other(s)
Are you looking for a full time or part time job?
Full time
Part time
Are you available right away?
Yes
No
If not, when could you start working?
Last place of work
City and state of last place of work
Position and activities
Entry date
Exit date
Supervisor
Reason for leaving the position
Can we ask for references in that place of work?
Yes
No
Criminal record
Yes
No
Do you have family or friends in the USA?
Yes
No
People who depend on you financially?
Yes
No
For you, how much money per week would be enough to have a good lifestyle?
$ 300
$ 600
If you had to choose, would you prefer:
$500/week with stability
$800/week with more effort
$1,000/week with hard work
$2,000/week with very demanding work
Refference 1
Refference 2
I confirm that the information provided on this form is true and understand that false or misleading information may be grounds for rejection or termination.
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I accept
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