Grupo Alfonso Portugal PHOTO ‘Sr. Antonio Costa Rus do Farol 2, 2740-028 Colares Portugal ‘APPLICATION FOR EMPLOYMENT Postion Applied For Date avaliable, Salary Requirements Nationality. aoe _ PERSONAL INFORMATION Name, nt ‘Middle Tast Previous Legal Name, int wide Tat Present Address Phone, ‘Saestand Namber Cay “State ‘mail Adress. Sosa Seurty# If hired can you provide proof of authorization to workin Europe? Yes) No] Areyontat east 8 sears age? Yes] No () Previously Employed by GA? Yes [JNo{] If Yes, in what Department? ___Date Terminated Relative Presently Employed by GA? C Yes 0 No If'Yes,Name___Relationship. Have you ever been convicted of, plead nolo contendere to, received deferred adjudication for, or are you under indictment for a rime other than a Class € Misdemeanor? [Yes (No A criminal conviction wil nt automatically disqualify you for ‘employment consideration, but a fase statement will.) EDUCATION ND SESS Name Location Circle numberof years completed ‘Type of degree (Grant or Antiipated) High Sehool Lag 4 oie college 1234 7 other ea ‘Total Number of College Hours Completed, GPA___College Major/Minor____ ‘Additional Training, Certification and Skills, inluding any received in the Military. Professional Certifications Applicants are considered for positions with Grupo Alfonso without regard to race, religion, color, sex, national origin, age, ‘marital or veteran status, disability or any other legally protected status. Grupo Alfonso /AA Employer. [EBIPLOYSGENT HISTORY (Begin with oar caren last poston and work back to your fick aclude any military expeenee) Most Recent Employment First bate rom, wo. Postion Held salay Mone Wolye Description of Duties, ‘Name of immediate Name of company Telephone Address Reason for Leaving.Date from. to Postion Held sali Mone Moly Description of Duties Name of immediate Name of Company. wae Telephone pares Reason for Leavin, Datefrom 0 Position Held salary Mone | Woh Description of buses Beant Name of immediate Name of Company Telephone. Addeess Reason for Leaving Tellus about any acleveront you have made in your previous working plac, Wy does this industyobcompany interest ou? ‘oyu wing to relocate? Yes} Ho] Doyou have any dsbiy? Yes) No ( ‘cory thatthe answers given herein ae true and compete. authorize the investigation of al statements contained in ths application ‘orm, including but not ited to, an investigation into my past and present employment, character, education, miltary, and criminal records to ascertain any and al information which may be partnent to my employment qualifeations hereby authorize anyone of whom 3 requests made to supply the Company any information concerning my background in connection with my being considered for ‘employment withthe Company. | hereby release al parties including but not nite tothe Compony, my personal eferences and my ‘revious employes, rom any anal laity for an/ injury or damage that may result fom tel furnishing information tothe Company ‘concerning me or any action the Company takes onthe basis of such information. understand this application shall not be given active consideration after Fifteen (10) days from ts ubmission, ln the event of employment, understand that: 8) Miepresentation or omission of facts on this application i cause for immediate dismissal: ‘bam required to and agree to abide by ll Company rules and regulations as a candtion of employment; «My employments at-will and is for no define pari of time, and as such, ether the Company oF may terminate the employment relationship with o without cause at any time; and 4) Certain postions may requir that | execute 9 confdentlty agreement and/or a noncompetition agement. derstand that this application, whether ar not | became employed by with Grupo Alonso, fenot intended tobe a contract of employment. | lo certify that this application was completed by me, and that alleties oni and Information nit are true and complete ‘othe best of my knowedge, “Signature of appieant Date