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Application assignment
- 1. Peoria Unified SchoolDistrict #11 Work Based Learning CTE/Professional Internship Employment Application DIRECTIONS: Read carefully and fill in ALL items. Incomplete or unsigned applications will not be accepted. __________________________________________________________________________________________________________________________ Last Name First Name Middle Initial __________________________________________________________________________________________________________________________ Address City State Zip Code __________________________________________________________________________________________________________________________ Home Phone Cell Phone E-mail __________________________________________________________________________________________________________________________ Birth Date Date Available Starting Time Work History Begin with your current or most recent position. List each promotion as a separate job. Include paid and voluntary positions. Be as accurate and complete as possible, especially in describing the duties of each position. Current or Most Recent Position: __________________________________________________________________________________________________________________________ Name of Employer/Company Job Title Dates of Employment (From - To) __________________________________________________________________________________________________________________________ Employer’s Address City State Zip Code __________________________________________________________________________________________________________________________ Name of Supervisor Hours Per Week Reason for Leaving Description of Duties: __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ Next Previous Position: __________________________________________________________________________________________________________________________ Name of Employer/Company Job Title Dates of Employment (From - To) __________________________________________________________________________________________________________________________ Employer’s Address City State Zip Code __________________________________________________________________________________________________________________________ Name of Supervisor Hours Per Week Reason for Leaving Description of Duties: __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ Coleman Kayla A. 8838 W. Aster Dr. Peoria AZ 85381 6023151840 6026636019 kaylaangeliquecoleman@gmail.com 08/16/1999 08/20/2016 8 am Humble Pie Hostess October 2015- Present 15703 N 83rd Ave Peoria AZ 85382 Calee Scott 8 Not enough hours Seating customers, bussing table, answering phones, taking Togo orders and hourly bathroom checks. Humble Pie Food runner/Expo October 2015-Present 15703 N 83rd Ave Peoria AZ 85382 Rachel 8 Not enough hours Running food to tabels, packing Togo orders, brigning clean dishes forward, bussing tabels, refilling sauces, taking out and replacing expired products
- 2. Education and Training College: __________________________________________________________________________________________________________________________ Nameof College Dates Attended - Month/Year __________________________________________________________________________________________________________________________ Address City State Zip Code __________________________________________________________________________________________________________________________ Classes High School: __________________________________________________________________________________________________________________________ Name of High School Dates Attended - Month/Year __________________________________________________________________________________________________________________________ Address City State Zip Code Use this space to identify any career and technical education classes you have received a “C” or better (i.e., Welding, Ag, Media, Culinary, Business Foundations, Life FACS, Drafting, Child Development, etc). __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ List any relevant certificates and licenses (Food Handlers, CPR, etc.), or specialized classes you have taken (i.e., Chemistry, Anatomy, Journalism, Photography, etc.) __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ Please give any additional information you feel is pertinent that is not listed elsewhere. Do not leave it blank . __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ List Three References __________________________________________________________________________________________________________________________ Reference #1: List name Address City State Zip Code Phone Number __________________________________________________________________________________________________________________________ Reference #2: List name Address City State Zip Code Phone Number __________________________________________________________________________________________________________________________ Reference #3: List name Address City State Zip Code Phone Number Signature: By signing this application, you are certifying that the information is true and complete to the best of your knowledge. Unsigned applications will not be considered. __________________________________________________________________________________________________________________________ Signature Date N/A Centennial High school August 2013 May 2017 14388 N 79th Ave Peoria AZ 85381 Design and Merchandising and Intro to Sports Medicine Chemistry, Dance, Sociology and Psychology Help coach at prestige cheer and gymnastics Patty Bowers 5295 W Phelps Rd # 1 Glendale Az 85306 602-548-8252 Ian Brown 15703 N 83rd Ave Peoria AZ 85382 (623) 334-2700 Roxy Terjesean 14388 N 79th Ave Peoria Az 85381 (623) 412-4400