PERSONAL INFORMATION AND DESIRES

DESIRED FISHERMAN'S LOCATION *
Select One Banning Palm Springs Palm Desert La Quinta
    
FULL NAME *

    
ADDRESS *

    
TELEPHONE # *

    
EMAIL
    
    
DESIRED POSITION *

    
DATE AVAILABLE *

    
DESIRED HOURS *
Select One Full Time Part Time Temporary
    
DESIRED SHIFT *
Select One Anytime Morning Shift Evening Shift
    
DESIRED DAYS * (Please separate DAYS with commas or put ANYTIME)

    
DESIRED SALARY *

    
ARE YOU OVER 18 *
Select One Yes No
    
RESIDENT STATUS *
Select One Citizen Legal Alien

EMPLOYMENT
(List your employment over the past five (5) years)
   

MOST RECENT EMPLOYER SECTION
     
COMPANY NAME & IMMEDIATE SUPERVISOR *

    
EMPLOYERS TELEPHONE *

    
EMPLOYERS ADDRESS *

    
SUMMARIZE REASON FOR LEAVING *

    
DATE EMPLOYED *   FROM - TO

    
SALARY/WAGE *

    
JOB TITLE / SUMMARY OF YOUR WORK *

   

SECOND MOST RECENT EMPLOYER SECTION
If the previous "Most Recent Employer Section" represents 5 years or more, DO NOT fill in the SECOND or THIRD MOST RECENT EMPLOYER SECTIONS.  Otherwise, please show at least 5 years employment history.

COMPANY NAME & IMMEDIATE SUPERVISOR

    
EMPLOYERS TELEPHONE

    
EMPLOYERS ADDRESS

    
SUMMARIZE REASON FOR LEAVING

    
DATE EMPLOYED     FROM - TO

    
SALARY/WAGE

    
JOB TITLE / SUMMARY OF YOUR WORK

   

THIRD MOST RECENT EMPLOYER SECTION

COMPANY NAME & IMMEDIATE SUPERVISOR

    
EMPLOYERS TELEPHONE

    
EMPLOYERS ADDRESS

    
SUMMARIZE REASON FOR LEAVING

    
DATE EMPLOYED     FROM - TO

    
SALARY/WAGE

    
JOB TITLE / SUMMARY OF YOUR WORK

 

REFERENCES

FIRST REFERENCE NAME *

    
FIRST REFERENCE TELEPHONE *

SECOND REFERENCE NAME *

    
SECOND REFERENCE TELEPHONE *