Employment Application
Now Playing: here now man
APPLICATION FOR EMPLOYMENT
PERSONAL INFORMATION
Romero, James J. 550898064
(Last) (First) (MI) Social Security Number
17087 E. Manning, Reedley CA 93654 D5424875
(Address) (City) (State) (Zip) Driver License #
N/A N/A N/A N/A (559) 637-1175
(Address) If different (City) (State) (Zip) Phone Number
Fresno CA 03/10/1986
Birth (City) (State) Date of Birth
EMPLOYMENT INFORMATION
What is the position you are applying for? Warehousing / Fork lifting
What is your availability for work? Full-time or Part-time
Have you worked for this company before? No
Are you legally able to work in the United States? Yes
Are you 18 years of age or older? Yes
Are you related to anyone who currently works for our company? No
Have you ever been convicted of a felony? No
EDUCATION
Sanger High School 12 H.S. Diploma
(High school) Level Completed Degree/Major
EMPLOYMENT HISTORY
Service Champ 2003-04 3117 S. Willow Ave., Fresno, Ca 93725 Material Handler
Company Dates Employed (Address) (City) (State) (zip) Job title
Reason for leaving: School
Sierra Electronic 2001-02 P.O. Box 533, Ahwahnee, Ca 93601 Assembler
Company Dates Employed (Address) (City) (State) (zip) Job title
Reason for leaving: School
SKILLS
List any special skills that you have which may relate to the position for which you are applying.
General warehouse duties including operating forklift, loading trucks, inventory, create clean environment, and filling/ delivering of orders.
PROFESSIONAL/PERSONAL REFERENCES
Delores Payan 17087 E Manning Ave. Reedley, Ca 93654 (559) 790-1712 Electronic Assembler
(Name) Address (city) (State) (Zip) Phone Number Occupation
Henry Uribe N/A N/A N/A N/A (559) 679-3721 Youth Counselor
(Name) Address (city) (State) (Zip) Phone Number Occupation
Scott Callison 1026 E. Simpson, Fresno, Ca 93604 (559) 679-3721 Youth Counselor
(Name) Address (city) (State) (Zip) Phone Number Occupation
READ THE FOLLOWING CAREFULLY, THEN SIGN AND DATE THE APPLICATION
1. Information that I have on this application is true and correct to the best of my knowledge. Any false statement of deliberation omission of the facts will be justification for the refusal of employment, or if employed, termination.
2. You may verify all of the information provided by me, including but not limited to education and employment, and may use an outside company to conduct the investigation.
3. I consent to take a pre-employment medical examination, if required, and any future physical examination as may be required by the company,
4. As a condition of employment a drug screening urinalysis is required. Failure to successfully complete the required drug screening process will result in rejection.
5. I understand that if I am employed, my employment is for no specific term. I further understand that my employment is terminable, with or without notice, at the will of either the company or myself. This means that I can resign at any time and for any reason, and the Company may terminate my employment at any time and for any reason not prohibited by law.
_______________________________________ ________________________________________
Applicants Signature Date