EMPLOYMENT APPLICATION

 

EMPLOYEE INFORMATION




Position (required) Salary Desired ($/Week) (required)
First Name (required) Last Name (required)
Telephone (required) Email (required)
Alternate Telephone Date of Birth (required)
Address (required) Social Security (required)
Sex Marital Status (required)
Number of Children if any Are you able to perform the essential functions of the position without accommodations?
YesNo
If necessary for the job are you older than: Are you legally eligible for employment in Belize?
under 13141821 YesNo
Are you seeking a Temporary or Permanent Position: How many days after being hired would you be able to report to work?
TemporaryPermanent
If necessary for the job, are you able to work overtime? Provide a valid Belize Driver's License?
YesNo YesNo

License Class: Issuing City/Town:
Which shifts are you willing to work?
BreakfastLunchDinnerRegular Office HoursAny/ All





EMPLOYMENT HISTORY



1.

Employer/Business Name: Pay per week:
Position title/duties/skills:
Supervisor: Telephone:
Start Date: End Date:
Reason for Leaving:

2.

Employer/Business Name: Pay per week:
Position title/duties/skills:
Supervisor: Telephone:
Start Date: End Date:
Reason for Leaving:

3.

Employer/Business Name: Pay per week:
Position title/duties/skills:
Supervisor: Telephone:
Start Date: End Date:
Reason for Leaving:



EDUCATION






Institution Name Years Completed Field of Study Graduate or Degree
High School
College/ University
Business/ Technical
Additional





SKILLS & QUALIFICATIONS



Other qualifications such as special skills, abilities or honors that should be considered:

Types of computers, software, and other equipment you are qualified to operate or repair:

Professional licenses, certifications or registrations:

Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to the employer’s attention:




REFERENCES



List two personal references who are not relatives or former supervisors.



Name Address Telephone Occupation Years Known
1.
2.





CONTACT






In case of accident or illness, please contact:


Name Address Telephone Relationship





INFORMATION TO THE APPLICANT



As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the Belize, have a drug test, or to sign a conflict of interest agreement and abide by its terms.

I understand and agree to the information shown above. Yes

Application Date:

By submitting the above application I agree to provide a Recent Police Record
YesNo

Applicant's Comments/Remarks:

File Attachment: