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Employment Application Form

Barri is an Equal Opportunity Employer. We consider every applicant for every position without discrimination of race, color, religion, gender, nationality, age, mental or physical disability, marital status, veteran of war condition, sexual orientation, or any other condition stated by the law.

Personal information (please print)

First Name

Middle Name

Last Name

Street

Apartment

Telephone Number

City/town

Zip code

What would your starting date be?

Do you have authorization to work in the U.S.A.?

Yes No

How did you hear about Barri?

Education

School

Curso de Estudio

Diploma/Certificado

College

Curso de Estudio

Diploma/Certificado

University

Curso de Estudio

Diploma/Certificado

Other

Curso de Estudio

Diploma/Certificado

Are you willing to work in different shifts?

Yes No

Are you willing to work during weekends?

Yes No

Have you worked with this company before?

Yes No

If yes, please indicate when

Are you currently working?

Yes No

If yes, can we contact your current employer?

Yes No

Can you successfully perform the activities demanded by the position you are applying for?

Yes No

Have you been declared guilty by any offense?

Yes No

Do you live with anybody that has been declared guilty of a criminal offense?

Yes No

(If yes, please explain why. An affirmative answer does not disqualify the applicant for the hiring process in Barri Remittance Corporation.)

Special Skills

Computer	Ms Excel	Copy Machine
MS Word	Fax	Máquina de escribir

Inglés

% Speak

% Read

% Writer

Other skills

Work Experience

Please indicate your last 3 positions held, beginning by the most recent one. Also, please indicate any other position you have held outside the U.S. You are authorized to exclude organizations that indicate your race, color, religion, gender, nationality, mental or physical disabilities, or any other condition stated by the law.

Company Name

Position

Start Date

End Date

Salary

City

State

Reason for leaving

Responsibilities

Phone Number

Company Name

Position

Start Date

End Date

Salary

City

State

Reason for leaving

Responsibilities

Phone Number

Company Name

Position

Start Date

End Date

Salary

City

State

Reason for leaving

Responsibilities

Phone Number

References

Name

Relationship

Phone Number

Name

Relationship

Phone Number

Name

Relationship

Phone Number

I certify that the information above is true and complete. I authorize the verification of the information related to previous job positions, education and associations, and I understand that any false information or documentation, or lack of relevant information may be cause of rejection of my application, disciplinary measure or firing.

We are an Equal Opportunity Employer / Esta empresa ofrece igualdad de oportunidad en el empleo