HomeMy WebLinkAboutReel_0024C (13)t ?.
r 12. Talents or SpecLaL SkLLLs
13. Do you have any actLvLtLes, commLtments or responsLbLLLtLes that may
prevent you from meetLng work attendance reouLrem
t
Y
"
-
en
s:
es
No .?
Comments:
14. Do you have any handLcaps that may affect work performance whLch you
feel should be taken Lnto account Ln determLnLng job placements
:
Yes No If yes, pLease expLaLn:
ti
1S. Do you have any problems Ln becoming LawfuLLy employed Ln thLs country
because of vLsa or LmmL
tL
t
gra
on s
atus: Yes No
° 16. Can you provLde proof of cLtLzenshLp, vLsa or aLLen reglstratLon
number after beLng hired: Y
N
'' es
o
Comments:
4
17. Have you had experience Ln the foLLowLng:
(a) CarryLng out varLng job sLtuatLons Yes No
(b) M
anual Labor Yes ? No
(c) OutsLde Work Yes- No -
(d) Use of general hand tools Yes ? No
(
) U
e
se and maintenance of power saws Yeses-_No
(f) DrLvLng truck Yes .l*? No - '
(g) OperatLng smaLL equLpment Yes ? No
(h) H
d
a
others work under your Lnstructions Yes ? No
(L) W
kL
or
ng wLth others and the pubLLc YesNo_
Comments on the above:
18. ave you been conv?c a or have you served: Lme Ln a correctLonaL
facLLLty wLthLn the past seven (7)
` years, for any crLme which might
have some bearLng on your- quaLLfLcatLon and fLtness to acce
t th
p
e
dutLnes and responsLbLLLtLes of the posLtLon for which you are apply-
Lng? Yes No ?
If yes, pLease kLve detaLLs
y
i>z c i1 r?...
''
19. PLEASE READ THE FOLLOWING AND SIGN BELOW:
1 certify that aLL state P-Qks above are true and to the best of my
knowledge. 1 underst ha false statements shaLL be suffLcLent
caul r Lnatlo
Lgnaturc o Ap ',cant / I - Date
form 100c
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