21THINGS4STUDENTS

Employment Application

APPLICANT INFORMATION
Last Name

Esleawa

Street
Address

Dat
e
Apartment/Unit
#

First

Sara

M.I.

State

MI

ZIP

3229 Metropolitan PKWY

City

Sterling Heights

Phone

586-350-2568

Date
Available
Position Applied
Walgreens
for
Are you a citizen of the United
States?
Have you ever worked for this
company?
Have you ever been convicted of a
felony?

10/6/2015

48310

E-mail
sesleawa@gmail.com
Address
Social Security
Desired
20158645900
No.
Wage:

YES X

NO

If no, are you authorized to work in the

U.S.?

YES

NO X

If so, when?

YES

NO X

If yes,
explain

YES X

EDUCATION (PLEASE LIST MOST RECENT FIRST)

School 1

Sterling Heights High School

Addres
s

From

1
9

YES X

School 2
From

To

2002

Did you
graduate?

Addres
s

Michigan State
2
0

To

2007

NO

Did you
graduate?

YES X

NO

Addres
s

School 3
From

To

Did you
graduate?

YES

NO

REFERENCES
Please list three professional references you have known at least 3 years and are not friends or relatives.
Full Name

Nejat Toma

Relationshi
p

Company

Antonios Transportation

Phone

Address

26625 Groveland Sterling Heights MI 48310

Full Name

Rony Seeba

Relationshi
p

Company

Ronys workshop

Phone

Address

2349 Metropolitan PKWY Sterling Heights 48310

586-502-8611

A workshop owner

586-222-3366

Full Name

Relationshi
p

Company

Phone

Address

College teacher

NO

PREVIOUS EMPLOYMENT
Company

Antonios Transportation

Phone

Address

1188 Jamestown

Superviso
r

Job Title

Pure Trucks

Responsibilities

Starting
Salary

Ending
Salary

$ 1500

$ 1800

To
2013

YES X

NO

Company

Ronaldo CK

Phone

Address

7752 Rainbow Street

Superviso
r

Job Title

Shopping

Responsibilities

Starting
Salary

2013

586-624-6381
Ronaldo Polis

$ 1400

Ending
Salary

$ 1900

Ending
Salary

Cashier

Reason for Leaving

Got enough money
for college
May we contact your previous supervisor for a
reference?
From

Dheia Oraha

Give out the salarys and responsible for typing and printing out papers for workers next place

Reason for Leaving

The job got harder
and a lot of
confusion
May we contact your previous supervisor for a
reference?
From
2011

586-350-2211

To
2015

YES X

NO

Company

Phone

Address

Superviso
r
Starting
Salary

Job Title

Responsibilities
From

To

Reason for Leaving

May we contact your previous supervisor for a

reference?

YES X

NO

MILITARY SERVICE
Branch

From

To

Rank at Discharge

Type of Discharge

If other than honorable,

explain

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview
may result in my release.
Signature

Sara Esleawa

Date

10/7/2015