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: