BEEKEEPERS APPLICATION FORM 2014.
Enviado por tany9577 • 19 de Noviembre de 2015 • Apuntes • 522 Palabras (3 Páginas) • 122 Visitas
APPLICANT INFORMATIONINFORMACION DEL SOLICITANTE | |||||
First Name | Last Name | ||||
Marital Status | Date of Birth | (MM/DD/YYYY) | |||
Social Security No. | Passport No. Pasaporte No. | ||||
Street Address Calle | Apartment/Unit# Numeración | ||||
City | State | ||||
Zip Code | Country | ||||
Primary Phone # Telef. Primario # | Alternate Phone # | ||||
Cellular Phone #1 Telef. Celular #1 | Cellular Phone #2 Telef. Celular #2 | ||||
Email address Dirección de email | |||||
Alternate Email address Dirección de email alternativa | |||||
Height | Ft. | Weight | Lb. | Body type | ◻ Thin ◻ Normal ◻ Heavy |
Do you smoke? Es fumador? | YES | NO | |||
Are you in good health? Goza Ud. de buena salud? | YES | NO | If no, which disease? | ||
Have you ever been granted with an USA Visa? | YES | NO | If yes, what type(s)? | ||
Have you ever traveled to the USA? | YES | NO | If yes, how many times? | ||
Do you have a driver’s Licence? | YES | NO | If yes, what type? | ||
ENGLISH SKILLSNIVEL DE INGLES | |||||
Please rank your English skills from 10% to 100% Favor califique su conocimiento del inglés del 10% al 100% | |||||
I Understand | YES | NO | If yes, Please rank | % | |
I Speak | YES | NO | If yes, Please rank | % | |
I read | YES | NO | If yes, Please rank | % | |
I write | YES | NO | If yes, Please rank | % | |
EMERGENCY CONTACT INFORMATIONINFORMACION DE CONTACTO DE EMERGENCIA | |||||
Please list the contact information of the person we should call in case of emergency Favor indique la información de contacto de la persona que debemos llamar en caso de emergencia | |||||
Name | Relationship | Phone | |||
Name | Relationship | Phone | |||
Name | Relationship | Phone |
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