APPLICATION FOR EMPLOYMENT

June 21 2016
DATE: ___________________________

PERSONAL INFORMATION
NAME (LAST NAME, FIRST)

Olga M. Salgado

PRESENT ADDRESS

CITY

294 A 16 St Bo San Isidro

PERMANENT ADDRESS
PHONE NO.

SOCIAL SECURITY NO. (LAST FOUR DIGITS)

XXX-XX- 8133
STATE
ZIP CODE
PR

Canovanas

CITY

00729

STATE

ZIP CODE

REFERRED BY

(787) 765- 4113

EMPLOYMENT DESIRED
POSITION

DATE YOU CAN START

SALARY DESIRED

inmediately

Administrative Assistant

ARE YOU EMPLOYED? Yes No

$10.00

IF SO, MAY WE INQUIRE OF YOUR PRESENT EMPLOYER? Yes No

yes

Yes

EVER APPLIED TO THIS COMPANY

no
BEFORE? Yes No

WHERE?

WHEN?

EDUCATION HISTORY
NAME AND LOCATION OF SCHOOL
HIGH
SCHOOL
COLLEGE

YEARS
ATTENDED

DID YOU
GRADUATE?

1980 -1983

Graduate

Luis Hernaiz High School

National College

SUBJECTS STUDIED
High School
diploma
Associate Degree

Rio Grande PR

2010

Graduate

Office Systems

TRADE OR
BUSINESS

GENERAL INFORMATION
SUBJECTS OF SPECIAL STUDY/RESEARCH
WORK OR SPECIAL TRAINING/SKILLS

Microsoft Programs, Excellent comunication skills, Medical

billing, Inmediata, Costumer service, Fast typing 60 wpm, bilingual

US MILITARY OR NAVAL SERVICE

No

RANK

FORMER EMPLOYERS (LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH LAST ONE FIRST)
DATE
MONTH AND
YEAR
FROM
2009

TO currently

NAME AND ADDRESS OF

EMPLOYER
Edwin Cuevas,MD
500 Domenech Suite 304
San Juan, PR 00918

SALARY

POSITION

REASON FOR
LEAVING

Medical Secretary
$9.00

FROM
TO
FROM
TO
FROM
TO

REFERENCES GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN FOR
AT LEAST ONE YEAR

NAME

ADDRESS

BUSINESS

YEARS
KNOWN

Executive Secretary

30 years

293 St Bo San Isidro 29

Lizbeth Lopez

Odette Morales
Sigfredo Perez

Canovanas PR 00729
J21 St Villas de Loiza
Canovanas, PR 00729
Tabonuco St Quintas de Canovanas
Canovanas PR 00729

Secretary
Security Supervisor

30 years
20 years

AUTHORIZATION
I certify that the facts contained in this application are true and complete to the best of my knowledge and
understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above
to give you any and all information concerning my previous employment and any pertinent information
that may have, personal or otherwise, and release the company from all liability for any damage that may
result from utilization of such information.
june 21, 2016
Olga M. Salgado Rios
DATE ______________________________
SIGNATURE __________________________________________