Call Center Truck Loader

Application for Employment

ADMINISTRATIVE OFFICE 1340 Arnold Drive, Suite 127 Martinez, CA 94553 ph 925-***-**** A Nonprofit, Community Organization Serving Children and Adults with Developmental Disabilities Since 1965 www.vistability.org GENERAL INFORMATION 12/10/2022

Last Name First Name Middle Name Nick Name

Misquez Laura Ann

Other Names Used

Portillo

Street Address City, State Zip Last 4 digits of SSN Fun To2475Grimsby dr Antioch, CA 94509 2680

Email Contact Phone Home Phone Cell Phone

**********@*******.*** 209-***-**** 209-***-****

If you are hired can you present proof of your legal right to work in the United States? X Yes No Are you at least 18 years of age? X Yes No If not, hiring may be subject to verification of age and a valid work permit. Have you ever worked for VistAbility before? Yes X No If yes, list dates and supervisor(s): Do you have any friends or relatives that work for VistAbility? Yes X No If yes, enter their names and relationship to you: Are you currently on "lay-off" status and subject to recall? Yes X No If hired, would you have a reliable means of transportation to and from work? X Yes No If required for this position, do you possess a valid driver's license? X Yes No If so enter State, License # and Class:

California n8061927. Class C

If a driver's license is required, have you received any tickets in the last three years for moving violations? Yes X No If so, list the date and type of each violation:

POSITION

Position applied for or type of position desired:

R6903- Day Program Caregiver for Adults with Disabilities Can you perform the essential functions of the job you are applying for, with or without reasonable accommodation? X Yes No

Available For:

X Full time

Part time

Temporary

On-call

Available Shifts:

X Days

X Swing

X Evenings

X Rotating

Weekends

When can you start? Now

If required can you work overtime? X Yes No

Are you willing to travel? X Yes No Restrictions: No How did you hear about this position? Indeed

EDUCATION AND TRAINING

Are you a high school graduate? X Yes No If not, have you passed the GED? Yes X No List your Colleges, Business Schools, and Vocational Schools and Military Training (with the most recent first). You may use

"+ Add Another Education" to add additional entries. Name and Location # of Yrs Attended Major/Area of Study Degree(s) Business school Uriah Business school. Uriah Ca

2 years. Business. Certificate

Vocational school

Nurses classes

and construction

Los Medanos

College.

LosMedanos

College.

High school

Bachman hill

high Po.box 627

Bo

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List any academic honors, scholarships, fellowships, academic honorary societies, etc. Citizens commendation Award for Distinguished service to Contra Costa County Law Enforcement WORK EXPERIENCE

List your work experience, starting with your most recent employment (do NOT enter "see resume"). You may use "+ Add Another Job" to add additional entries.

Employer Address

Wine country care center 321 west Turner rd Lodi Ca Supervisor(s) Name,Title May we contact this employer? Phone Eligible for rehire? Susie Hernandez X Yes No 1-916-***-**** Yes X No

Starting Date Ending Date Reason for Leaving

5/5/2000 10/25/2010 Moved to another town

Starting Title Starting Duties

Dietitian Cooked,set trays for breakfast 'lunch 'dinner '.make sure their diets were correct, help feed the elderly party planning sometime entertaining them, made snacks ect. Ending Title Ending Duties

Dietitian Same as above ditatary needs

Employer Address

UPS 1970 Oliver's rd Concord Ca

Supervisor(s) Name,Title May we contact this employer? Phone Eligible for rehire?

.Tim Supervisor X Yes No 1-916-***-**** Yes X No

Starting Date Ending Date Reason for Leaving

10/23/2022 11/4/2022 Physically Demanding

Starting Title Starting Duties

Sorting to loading trucks Sorting packages

Ending Title Ending Duties

Truck loader Loading heavy boxes to Ups trucks

Employer Address

Honey Baked Ham 1910 Concord ave.Concord ca

Supervisor(s) Name,Title May we contact this employer? Phone Eligible for rehire? Anthony X Yes No 925-***-**** X Yes No

Starting Date Ending Date Reason for Leaving

11/5/2022 12/31/2022 Seasonal

Starting Title Starting Duties

Greater,call center Taking orders and grating costumers at the door Ending Title Ending Duties

Door greater Stocking shelf's and putting items for display for sale and talking to customers and greating customers at the door OTHER SKILLS

If you are fluent in any languages other than English list them here with details (fluent, conversational, etc): None

List any special training, work-related skills, achievements, equipment certification, occupational licenses, military training, certifications or registrations relevant to this position. If hired, you may be required to submit copies for verification. Nurses certificate, food certification for handling food, CPR Saved some lives in my life time

List any Memberships in Professional or Civic Organizations. (Exclude those which may disclose your race, color, religion or nation origin).

None

State any additional information you feel may be helpful to us in considering your application. I'm on time, love to help people, always bring a good attitude to work and I'm a very hard worker and like to finish what I start

. My Husband heard that I was applying for this job and he said that this job would fit me perfectly because I love helping everyone.

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PROFESSIONAL REFERENCES

Enter the names and contact numbers of three (3) business/work references of people who are not related to you, or if not applicable you may enter school or personal references of people who are not related to you. Name Position/Company/Address Yrs Known Contact Number/Email kelly, Ellis. Traffic AP traffic

32y

****************@*****.***

Dana, Clifford Tesla Co 40yr danaclifford

@yahoo.com

Monica Shaffer, Home

maker 20yrs

************@*****.**

m

Adriana arceo email

Adriana.arceo@ outlook.com

35 yrs county worker

Ashely Ponce email *.*****@*****.*** 2 months

Honey Baked Ham

Suzie Hernandez

www.facebook/qsuzi

e.com wine country

N/A N/A N/A N/A

SIGNATURES (Initials and Signature were entered electronically and verified by applicant's email and password) LM I certify that the answers given herein are true and complete to the best of my knowledge. LM I authorize investigation of all statements contained in this application for employment as may be necessary in arriving to an employment decision.

LM In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of VistAbility. LM Fingerprint and / or background clearance is required for all positions. Laura Misquez 12/09/2022

Electronic Signature Date

PROOF OF CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT. Qualified applicants are considered for all positions without regard to race, color, religion, age, national origin, marital status or veteran status, or the presence of a non-job related medical condition or handicap, or any other legally protected status. An Equal Opportunity Employer

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Contact this candidate