Job Offer

Work & Travel program 2011

To be completed by Employer and signed by Employer and Student

1. Student information
First name /Last name: Andoni Marcela
Date of birth (mm/dd/yyyy): 06/13/1989 Country: Moldova
2. Employer information
Company Name:
Business description:
Street: City:
State: Zip:
Phone: Fax:
Tax ID Number (EIN): Website:
Supervisor's name: Phone:
Fax: Supervisor's email:
Off season phone:
3. Job information
Worksite address (if different from above):
Street: City:
State: Zip:
Dates of employment: From (mm/dd/yyyy): 06/15/2011 To (mm/dd/yyyy): 09/07/2011
Job title: (maximum of four (4) months)

Job description:
Specific skills needed:
English level: advanced intermediate beginner
Wage per hour: Tips: Yes No
Average number of hours per week: Payment schedule: daily weekly bi-weekly monthly
Are uniforms required: Yes No Cost:
Dressing and Grooming requirements:
Benefits: Meals: End of season bonus:
Housing: Provided by employer Not provided Assisted to find
If provided: Student must stay at housing provided Student may choose alternative housing
Housing fee: Per month Per week Utilities included? Yes No
Type of housing: Details:
Security deposit amount: Due date: Refundable amount:
Will you hire and pay wages without a Social Security card/number? Yes No
Note: it is legal to hire and pay workers who do not have a Social Security number but have proof of application for the card. See 26CFR31.6011(b)-2 of the Internal Revenue
laws. The DS2019 and I-94 form prove work authorization.

Company Representative completing this form (please print): _____________________________________

Position Title: ____________________________
Date (mm/dd/yyyy): _______________________ Company Representative’s Signature: ___________________

Student’s name (please print): ________________________________________________

Date (mm/dd/yyyy): ________________________ Student’s signature: _____________________________