APPLICATION FOR EMPLOYMENT

Date: 07/18/10 Please print clearly in ink and complete all information requested Name:
Last

Hernandez

First

Lorena

M. I.

Street Address:
1108 W Ralston st.
City:

Ontario

State:

Ca

Zip:

91762

Previous Address: (Complete only if at current address less than 2 years)

613 El Centro pl.

City:

Las Vegas

State:

Nv

Zip: 89104

Email Address:

hersalor@hotmail.com

Preferred Contact #: (909 ) 544-6730

POSITION DESIRED (A separate application must be provided for each position in which you are interested.) Position Applying for: utility worker (dining services) Salary Desired: Open to discussion Type of Work Desired: Full Time Part Time Posting Number: P1802 Date Available: 07/18/10 Either

PERSONAL INFORMATION 1. If hired, can you present proof of your legal right to live and work in the United States? 2. Are you at least 18 years of age or older? If no, a work permit may be required. 3. For reference purposes, have you worked or attended school under a former name? If yes, please list former name(s): 4. Have you ever worked for The Claremont Colleges? If yes, which college? 5. Are any relatives or members of your household currently employed at this institution? If yes, give full name and position. Rafael Hernandez /Special Events 6. Are you able to perform the essential functions of the position applied for, either with or without reasonable accommodation? 7. Have you ever been convicted of a crime or violation other than a minor traffic infraction? (Please do not include arrest or detentions that did not result in convictions or convictions for marijuana-related offenses that are more than two years old). If yes, please explain: (Note: A conviction is not an automatic bar to employment. The nature of the offense, date of offense, the surrounding circumstances and relevance of the offense to the position applied for will be considered.) 8. Have you ever been discharged from any employment, asked to resign or advised that if you did not resign, your employment would be terminated? If yes, please explain: 8. Yes No 1. 2. 3. 4. 5. Yes Yes Yes Yes Yes No No No No No

6.

Yes

No

7.

Yes

No

We are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should contact the Human Resources Office.

EDUCATION AND TRAINING Name and Location No. of Years Completed Did you graduate Major / Degree

Type of School

High School/ GED/CHSPE

Escuela Secundaria Federal

Yes

Business/Trade or Technical School College(s) or University(ies) Name of School / Course of Study:

Are you attending school now: SPECIAL SKILLS Licenses / Certificates

Yes

No

N/A
Keyboarding WPM: Computer Programs:

Answer only if position applied for requires a drivers license. Do you have a valid drivers license issued by the State of Yes No California?

N/A
Special Equipment:

Internet,Microsoft Office

N/A
List Foreign Language(s) (optional) Speak
Spanish
Learning English

Read

Spanish
Learning English

Write Spanish
Learning English

Interpret / and or translate

Do you have any other experience, training, qualification or skills, which you feel, make you especially suited for the position applied for?

Yes No
If yes, please explain:

I have 3 years experience in general Commercial Office and Housekeeping.I am a very responsible,honest and hard working person.

EMPLOYMENT HISTORY For the last 10 years, starting with most recent, list each job held and account for all periods of unemployment. Attach additional sheets if necessary. You must complete this section even if attaching a resume. EMPLOYER: Address: Supervisors Name: Start Date: 07/2008 Title or Position:
Rosa Galvan

Rosa Galvan Cleaning Services

May we contact this employer? Yes Phone: 702-296-4278

No

Phone: 702-296-4278 Starting Salary: $8 per hour Ending Salary: $10 per hour

Term Date: 08/2009

General Cleaner (Housekeeper)

Duties and Responsibilities: General maintenance,cleaning,cooking. (Commercial Office and Housekeeper)

Reason for Leaving:

Maternity leave.

Account for periods of unemployment between jobs:

08/2009 to Present

EMPLOYER: Address:

May we contact this employer? Yes City / State:

No

Bella Vista 135

Phone:

01152-495-1011566

Supervisors Name: Start Date: 11/1987 Title or Position:

Phone: 01152-495-1011566

07/2007

Starting Salary: Varied

Ending Salary:

Varied

Owner

Duties and Responsibilities:

Clothing manufacturing,sales,machine operator,administration.

Reason for Leaving:

Relocated to the United States as a legal permanent resident.

Account for periods of unemployment between jobs:

EMPLOYER: Address: Supervisors Name: Start Date: Title or Position: Duties and Responsibilities: Term Date: City / State:

May we contact this employer? Yes Phone: Phone: Starting Salary: Ending Salary:

No

Reason for Leaving: Account for periods of unemployment between jobs:

EMPLOYMENT HISTORY EMPLOYER: Address: Supervisors Name: Start Date: Title or Position: Duties and Responsibilities: Term Date: City / State: Phone: Starting Salary: Ending Salary: May we contact this employer? Yes Phone:

No

Reason for Leaving: Account for periods of unemployment between jobs: May we contact this employer? Yes City / State: Phone: Term Date: Starting Salary: Ending Salary: Phone:

EMPLOYER: Address: Supervisors Name: Start Date: Title or Position: Duties and Responsibilities:

No

Reason for Leaving: Account for periods of unemployment between jobs:

Important, please read carefully and sign. I hereby certify that the information on this application and all other information otherwise provided are true and correct. I understand that any misrepresentations or omissions will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered. If I am hired, I acknowledge that there is no specified length of employment and that this application does not constitute a contract for employment. I also understand that my needs, and/or the needs and resources of the College might change, requiring a change in personnel. Accordingly, either I or Pomona College can end the employment relationship at will, that is, at any time with or without a reason. I further acknowledge that the only way the at-will nature of my employment relationship with Pomona College can be altered is by a specific written agreement signed by me and the College President. I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions. Applicants Signature

Lorena Hernandez S.

Date:

07/18/2010