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Employment Center


Employment Center Information

Please Fill Out and Email To:
msliz4kidz@gmail.com or msliz4kidz@yahoo.com

                                         L & L Specialty Therapy/Care Tec Pediatric Center,LLC Website





L & L Specialty Therapy, LLC

2834 Military Highway, Pineville, La 71360

318-451-3989 CENTER  318-704-5821 FAX

337-351-1841  ADMINISTRATION

 

Care Tec Pediatric Center, LLC

2840 Military Highway, Pineville, La, 71360

318-704-5304 CENTER  318-704-5821 FAX

337-301-1029 ADMINISTRATION

           EMPLOYMENT APPLICATION
           
POSITION APPLIED FOR:_____________________________________                               DATE OF APPLICATION:_______________________________

          APPLICANT    HOME PHONE:__________________            CELL  or ALTERNATE PHONE:_______________

NAME:_____________________________________________________________________

            LAST                                                    FIRST                                       MIDDLE

ADDRESS:

______________________________________                                                            ARE YOU LEGALLY ELIGIBLE FOR US EMPLOYMENT?

______________________________________                                                               YES         NO  (IF YES VERIFICATION REQUIRED)

_______________________________________                                                            I AM SEEKING A PERMANENT POSITION: YES   NO

 

 

ARE YOU ABLE TO PERFORM THE ESSENTIAL FUNCTIONS  IF NECESSARY, FOR THE JOB I AM ABLE TO:

 MEET THE ADA REQUIREMENTS  OF THE POSITION I AM APPLYING FOR , WITH OR WITHOUT  ACCOMMODATION

 PLEASE SPECIFY :                                                                                                     WORK OVERTIME?         

                                                                                                                                         PROVIDE A VAILD DRIVER’S LICENSE?   

IF NECESSARY FOR THE JOB, ARE YOU OVER (PLEASE MARK ONE) 16__  18__  19__  21__

I WILL BE ABLE TO REPORT TO WORK ___ DAYS AFTER BEING NOTIFIED THAT I AM HIRED.

EDUCATION:

HIGH SCHOOL

YES COMPLETED

FIELD OF STUDY

GRADUATE OR DEGREE

 

 

 

COLLEGE/UNIVERSITY

 

 

 

BUSINESS/TECHNICAL

 

 

 

OTHER (MAY INCLUDE GRAMMAR SCHOOL)

 

 

 

MILITARY SERVICE:     YES    NO

DUTY/SPECIALIZED TRAINING:___________________________________________________________

 

REFERENCES: LIST TWO PERSONAL REFERENCES WHO ARE NOT RELATIVES OR FORMER SUPERVISORS.

_________________________________________________________________________________________________________

NAME                                ADDRESS                                           TELEPHONE                   OCCUPATION                           YEARS KNOWN

_________________________________________________________________________________________________________

NAME                                ADDRESS                                           TELEPHONE                   OCCUPATION                           YEARS KNOWN





EMPLOYMENT: LIST LAST EMPLOYMENT FIRST. INCLUDE SUMMER OR TEMPORARY JOBS. BE SURE ALL YOUR EXPERIENCE OR EMPLOYERS RELATED TO

THIS JOB ARE LISTED HERE, IN THE SUMMARY (FOLLOWING THIS SECTION) OR USE AN EXTRA SHEET OF PAPER IF NECESSARY.

EMPLOYER NAME AND ADDRESS:

POSITION TITLE/DUTIES SKILLS

DATES EMPLOYED

FROM                  TO

 

 

 

REASON FOR LEAVING

 

SUPERVISOR’S NAME: TELEPHONE

EMPLOYER NAME AND ADDRESS:

POSITION TITLE/DUTIES SKILLS

DATES EMPLOYED

FROM                  TO

 

 

:

REASON FOR LEAVING

 

SUPERVISOR’S NAME: TELEPHONE

EMPLOYER NAME AND ADDRESS:

POSITION TITLE/DUTIES SKILLS

DATES EMPLOYED

FROM                  TO

 

 

 

REASON FOR LEAVING

 

SUPERVISOR’S NAME: TELEPHONE

EMPLOYER NAME AND ADDRESS:

POSITION TITLE/DUTIES SKILLS

DATES EMPLOYED

FROM                  TO

 

 

 

REASON FOR LEAVING

 

SUPERVISOR’S NAME: TELEPHONE

 

SUMMARIZE OTHER EMPLOYMENT RELATED TO THIS JOB__________________________________________________

 


TYPES OF COMPUTERS, OTHER ELCTRONIC, OR MECHANICAL EQUIPMENT THAT YOU ARE QUALIFIED TO OPERATE OR REPAIR:__________________________________________________________________________________________

 


PROFESSIONAL LICENSES, CERTIFICATIONS OR REGISTRATIONS: _____________________________________________

 


ADDITIONAL SKILLS INCLUDING SUPERVISION SKILLS, OTHER LANGUAGES, OR INFORMATION REGARDING THE CAREER/OCCUPATION YOU WISH TO BRING TO THE EMPLOYER’S ATTENTION______________________________________________________________________________________

_______________________________________________________________________________________________________________________




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Care Tec Pediatric Center, LLC

2840 Military Highway,

Pineville,La 71360

 

Phone:   337-301-1029 or 

318-451-3989    

Center: 318-704-5304

Fax: 318-704-5821
Email: msliz4kidz@yahoo.com

msliz4kidz@gmail.com

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