Part-Time Material Handler

EMPLOYMENT / JOB APPLICATION

PERSONAL INFORMATION

FULL NAME: Grondon fait Arriaga DATE: of~ G-2024

First idle Last

appress: (10 Columbine St

Street Address ‘Apt/Suite

Amauri? Tx 74\ oF

City State Zip Code

E-MAIL: h(anden Yairarriogn@ Qrraile com PHONE: Bb 06 584 $0

SOCIAL SECURITY Bee (ssn): 631 AS 7 556

DATE AVAILABLE: O oO baad 24 DESIRED PAY: $ \3 @fiour O satay

POSITION APPLIED FOR: \Warce houSe- Material Handler

EMPLOYMENT DESIRED: Pere O part-time 0 SEASONAL

EMPLOYMENT ELIGIBILITY

ARE YOU A U.S. CITIZEN? &.. Ono

*IF NO, ARE YOU ALLOWED TO WORK IN THE U.S.? CO yes 01 no

HAVE YOU EVER WORKED FOR THIS EMPLOYER? (1 ves: SBR®?

*IF YES, WRITE THE START AND END DATES:

HAVE YOU EVER BEEN CONVICTED OF A FELONY? 1 ves: GORD

*IF YES, PLEASE EXPLAIN:

EDUCATION

HIGH aco oho duro city state: Anas lla {kK

From: @ 9 2 to: LOU

GRADUATE? G ves Cio DIPLOMA:

COLLEGE: CITY / STATE:

FROM: TO:

GRADUATE? O yes 0 no DEGREE:

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