Employment Application

APPLICANT INFORMATION

Last Name Piedra First Name Samuel Birthdate 09/08/2000

Address 29th Street, 60th Avenue.

City San José Canton San José State San Francisco de Dos Ríos

Phone +506 8303 8300 E-mail Address samuelp0809@gmail.com

Date Available Right now Cédula No. 1 1789 0065 Salary expectations 400 000

Position Applied for 3D Dental Treatment Designer

Are you a citizen of Costa Rica? YES x NO ☐ If no, are you authorized to work in the country? YES ☐ NO ☐

Have you ever worked for this company? YES ☐ NO x If so, when?

Have you ever been convicted of a felony? YES ☐ NO x If yes, explain

EDUCATION

High School Colegio Vocacional Monseñor Sanabria Address

From 2016 To 2018 Did you graduate? YES x NO ☐ Degree Medium Education Bachelorship

College Address

From To Did you graduate? YES ☐ NO ☐ Degree

Technical Colegio Vocacional Monseñor Sanabria Address

From 2016 To 2018 Did you graduate? YES x NO ☐ Degree Industrial Electronic

Other Universidad de Costa Rica Address

From 2021 To today Did you graduate? YES ☐ NO x Degree B.S. in Physics

REFERENCES
Please list three professional references.

Full Name Jose Antonio Arce Flores Relationship Teacher

Company Colegio Vocacional Monseñor Sanabria Phone +506 8554 0571

Email

Full Name Relationship

Company Phone

Email

Full Name Relationship

Company Phone

Email
PREVIOUS EMPLOYMENT

Company Infotree Global Services Phone

Address Heredia, Belén. Supervisor Pablo Arrieta

Job Title Manufacturing Technician Starting Salary $765 Ending Salary $700

Responsibilities Machine operator.

From 2020 To 2021 Reason for Leaving Change in transport policies.

May we contact your previous supervisor for a reference? YES ☐ NO x I don’t have his contact.

Company CR Conectividad Phone

Address San José, San Pedro Supervisor Don’t remember.

Job Title Technician Starting Salary $ Ending Salary $

Responsibilities Installation and maintenance of audiovisual devices.

From 2018 To 2018 Reason for Leaving It was temporal.

May we contact your previous supervisor for a reference? YES ☐ NO x

Company Phone

Address Supervisor

Job Title Starting Salary $ Ending Salary $

Responsibilities

From To Reason for Leaving

May we contact your previous supervisor for a reference? YES ☐ NO ☐

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.

I authorize Align Technologies de Costa Rica SRL to investigate my background and qualifications for purposes of evaluating whether I am qualified for the
position for which I am applying. I understand that Align Technologies Costa Rica will utilize an outside firm or firms to assist it in checking such information, and
I specifically authorize such an investigation by information services and outside entities of the company's choice. I also understand that I may withhold my
permission and that in such a case, no investigation will be done, and my application for employment will not be processed further.

Signature Date 05/07/2000