1. Peoria Unified School District #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.
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Last Name First Name Middle Initial
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Address City State Zip Code
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Home Phone Cell Phone E-mail
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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:
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Name of Employer/Company Job Title Dates of Employment (From - To)
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Employer’s Address City State Zip Code
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Name of Supervisor Hours Per Week Reason for Leaving
Description of Duties:
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Next Previous Position:
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Name of Employer/Company Job Title Dates of Employment (From - To)
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Employer’s Address City State Zip Code
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Name of Supervisor Hours Per Week Reason for Leaving
Description of Duties:
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Torres Jorge Luis T
8230 W. Voltaire ave Peoria Az 85381
N/A 6235229576 Jtorrres1229.jt@gmail.com
06/22/1999 9/2/2016 12:50Pm
Lanini management, inc crew worker 5/23/2016-current
7515 W. bell road Peoria Az 85382
Letty G. 35-40 N/A
Front counter cashier, Drive thru Cashier, Handout, Kitchen,Crew Trainer
N/A N/A N/A
N/A N/A N/A N/A
N/A N/A N/A
N/A

2. Education and Training
College:
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Name of College Dates Attended - Month/Year
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Address City State Zip Code
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Classes
High School:
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Name of High School Dates Attended - Month/Year
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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).
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List any relevant certificates and licenses (Food Handlers, CPR, etc.), or specialized classes you have taken
(i.e., Chemistry, Anatomy, Journalism, Photography, etc.)
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Please give any additional information you feel is pertinent that is not listed elsewhere. Do not leave it blank
.
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List Three References
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Reference #1: List name Address City State Zip Code Phone Number
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Reference #2: List name Address City State Zip Code Phone Number
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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.
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Signature Date
N/A N/A N/A
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N/A
Centennial High school 2013 2017
14333 N. 79th ave Peoria Az 85381
Building trades 1 and 2, Business Foundations.
Food Handlers, Chemistry
I am involved in Law enforcement club, French club, FCA(fellowship of Christian athletes).
I also Am involved in Football, Wrestling, Tennis.
Letty G. 7515 W. Bell road Peoria AZ 85381 623) 486-0613
Felix quintero 12951 N 83rd Ave Peoria Az 85381 623) 979-0193
Samuel G. 7515 W. Bell road Peoria AZ 85381 623) 486-0613
8/16/16