APPLICATION FOR EMPLOYMENT

This generic application is provided by WorkSource Washington. This form complies with federal and state laws against discrimination;
however, employers using this form should check local ordinances. WorkSource Washington and Washington State Employment Security
are not responsible for the misuse of information provided on this form. Provide all information requested by printing in ink or typing. Use
the 'TAB' key to move through the document.

GENERAL INFORMATION
Name (Last)
Villegas

(First)

Address (Mailing Address)

(City)

(Middle Initial)

Marc Kreistian

639 S Arroyo Ave

L
(State)

(559) 267 - 3396

(Zip)

Fresno

Other Telephone

() -

93727
C

E-Mail Address

Are you legally entitled to work in the U.S.?

marckreistian@yahoo.com

Home Telephone

Yes

No

POSITION
Position Or Type Of Employment Desired

Business Manager
Are you able to perform the essential functions of the job you are applying for, with or
without reasonable accommodation?
Yes
No

Will Accept:
Part-Time
Full-Time
Temporary

Salary Desired

Date Available

1,000,000,

Anytime

Shift:
Day
Swing
Graveyard
Rotating

EDUCATION AND TRAINING

High School Graduate Or General Education (GED) Test Passed?
If no, list the highest grade completed 11

Yes

No

College, Business School, Military (Most recent first)

Name and Location

NA
NA
NA
NA

Dates
Attended
Month/Year

From NA
To NA
From NA
To NA
From NA
To NA
From NA
To NA

Credits Earned
Quarterly or
Other
Semester
(Specify)
Hours

Graduate

NA

NA

Yes
No

NA

NA

Yes
No

NA

NA

Yes
No

NA

NA

Yes
No

Degree
& Year

NA
0
NA
NA
NA
0
NA
0

Major
or Subject
NA
NA
NA
NA

Occupational License, Certificate or Registration

Number

Where Issued

Expiration Date

NA

NA

NA

NA

Occupational License, Certificate or Registration

Number

Where Issued

Expiration Date

NA

NA

NA

NA

Occupational License, Certificate or Registration

Number

Where Issued

Expiration Date

NA

NA

NA

NA

Languages Read, Written or Spoken Fluently Other Than English

NA

VETERAN INFORMATION (Most recent)

Branch of Service

Date of Entry

Date of Discharge

NA

NA

NA

SPECIAL SKILLS (List all pertinent skills and equipment that you can operate)
(Maximum 1000 characters) I

can play the piano. I can also stay up all night to do work that needs to be done. I am organized
and always know where everything is located even if the environment might not be the neatest. I have experience in
managing people.

WORK EXPERIENCE (Most Recent First)

(Include voluntary work and military experience)

EMS 10171 CC 7540-032 635
ESD 1999 Rev. 12/30/03

() -

Employer NA
Address NA

Telephone Number

Job Title NA
Specific Duties (Maximum 1000 characters)

Number Employees Supervised

NA

NA

From (Month/Year)

NA
To (Month/Year)

NA
Hours Per Week

NA
Last Salary

NA
Supervisor

NA
Reason For Leaving

NA

May We Contact This Employer?

() -

Employer NA
Address NA

Telephone Number

Job Title NA
Specific Duties (Maximum 1000 characters)

Number Employees Supervised

NA

Yes

No

From (Month/Year)

NA
To (Month/Year)

NA
Hours Per Week

NA
Last Salary

NA
Supervisor

NA
Reason For Leaving

NA

Employer NA
Address NA

May We Contact This Employer?

Telephone Number

Job Title NA
Specific Duties (Maximum 1000 characters)

() -

Number Employees Supervised

NA

NA

Yes

No

From (Month/Year)

NA
To (Month/Year)

NA
Hours Per Week

NA
Last Salary

NA
Supervisor

NA
Reason For Leaving

NA

May We Contact This Employer?

() -

Employer NA
Address NA

Telephone Number

Job Title NA
Specific Duties (Maximum 1000 characters)

Number Employees Supervised

NA

Yes

No

From (Month/Year)

NA
To (Month/Year)

NA
Hours Per Week

NA
Last Salary

NA
Supervisor

NA
Reason For Leaving

NA

May We Contact This Employer?

Yes

No

I certify the information contained in this application is true, correct, and complete. I understand that, if employed, false
statements reported on this application may be considered sufficient cause for dismissal.

Signature of Applicant_________________________________________________________ Date________________

Interviewers Comments:

WorkSource Washington and Washington State Employment Security are equal opportunity employers and providers of employment and training services.
Auxiliary aids and services are available to persons with disabilities upon request.