809 959 0441
info@maximopotencial.edu.do
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Job application
Please answer the information provided here, it will be treated strictly confidential.
General Information
Name and surname of the applicant
Nickname
Age
Phone
Nationality
Date of birth
Place of birth
Current address
Area where you currently live
Marital status
Religion
Can you work where there are pets?
Select
Yes
No
Height
Weight
Email address
Housing type
Select
Own Housing
Rented house
How long
With whom do you live?
Record arrival time to the city center
Emergency contact
Phone
Available shift
Rotary
Monday-Friday
Monday-Saturday
Fin de semana
Friday-Sunday
Documentation
Identity card
Driver license
Social Security
Academic training
Currently study
Select
Yes
No
Current academic level
Current schedule
Plan to study in the future
Select
Yes
No
On what date
In what schedule
Education
Primary
High school
Technique
University
Other
Mental and physical health
Current health conditions
Good
Regular
Deficient
Current illnesses
Take medication?
Select
Yes
No
Dose
Availability for psychological evaluation through a test
Select
Yes
No
Availability for analytical tests
Select
Yes
No
Dropin
Select
Yes
No
Health insurance
Type of insurance
Category
Smokes
Select
Yes
No
Alcohol consumption
Select
Yes
No
Frequency
Have you used drugs?
Select
Yes
No
Have you been in conflict with the law?
Select
Yes
No
Job application
Province in which you want to apply
Can work in interior
Select
Yes
No
Has own vehicle
Select
Yes
No
Suggested time to work
Would you accept a trial period
Select
Yes
No
Labor Referral
Company name
Address
Labor time
Average salary
Type of work
Direct boss phone
Add
Company name
Address
Labor time
Average salary
Type of work
Direct boss phone
Add
Company name
Address
Labor time
Average salary
Type of work
Direct boss phone
Referrals
Name and surname
Phone
Address
Profession or occupation
Time that knows him
Add
Name and surname
Phone
Address
Profession or occupation
Time that knows him
Add
Name and surname
Phone
Address
Profession or occupation
Time that knows him
In your residence, with whom do you live?
How many people depend on you?
Current job status
Availability of working hours
From what date is it available?
Generals of the job you are applying for
Minimum wage for which it would be employed
Position you are requesting
Who referred you?
Do you know someone who is part of the company?
Select
Yes
No
Can you call your old boss?
Select
Yes
No
Name
Position
Long-term goals
Aspiration of studies
Future job aspiration
Training
Availability to be trained
Select
Yes
No
Availability
Santo Domingo
Inside the country
Outside the country
Familiar structure
Place you occupy within your family
Direct dependents
Languages
Candidate evaluation
Mention three qualities for which you distinguish yourself as an employee
Areas to improve
Rating of your performance
Attendance
Select
Excellent
Good
Regular
Unsatisfactory
Puntuality
Select
Excellent
Good
Regular
Unsatisfactory
Cooperation
Select
Excellent
Good
Regular
Unsatisfactory
Honesty
Select
Excellent
Good
Regular
Unsatisfactory
Knowledge of the firefighter job
Select
Excellent
Good
Regular
Unsatisfactory
Initiative
Select
Excellent
Good
Regular
Unsatisfactory
Productivity
Select
Excellent
Good
Regular
Unsatisfactory
Speed
Select
Excellent
Good
Regular
Unsatisfactory
Cash handling experience
Select
Excellent
Good
Regular
Unsatisfactory
Files attached to your request
Send
809 959 0441
info@maximopotencial.edu.do
