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.
Personal Information
Date 4/15/2013[pic]8/1/11
Name Collins Falanda Jean Previous 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.
Employment Desired
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