BELIZE WATER SERVICES LIMITED

INTERNAL APPLICATION FORM FOR EMPLOYMENT

DATE: ____________________________
1. FULL NAME OF APPLICANT:

______________________________________________________________________________________
First Name Middle Names Surname (underline if more than one)

2. a. SOCIAL SECURITY No.:_____________ b. NATIONALITY: ____________________ c.SEX: ___ (M/F)

3. a. PHONE NOs: ____________________________ b. Email address:___________________________

c. ADDRESS: ___________________________________________________________________________
No. Street Name Area/Village Town/City/District

4. PLACE OF BIRTH: _____________________________ DATE OF BIRTH____________________________

DAY/MONTH/YEAR

5. MARITAL STATUS: __________________________ (Single, Married, Common Law, Divorced, Separated)

6. PHYSICAL TRAITS: a. Weight: ___________lbs b. Height: _____________ft.______________ins.

7. a. POST SOUGHT: ______________________________ b. VACANCY CODE: _________________

8. EXPECTED SALARY: ________________________ per _____________________ (Year/Month/Week)

9. EDUCATION:
Completed? Dates Attended
School Name and Location Type* (Y/N) (From/To)

*Type: P=Primary School, S=Secondary/High School, U=University/6th Form, T=Technical/Vocational, O=Other

Form: BWS-InternalApp-V2014-09
 BWS APPLICATION FOR EMPLOYMENT

10. DIPLOMAS OR CERTIFICATES:

Diploma or Certificate Issued by (School or Examining Agency) Date awarded

11. BRIEFLY DESCRIBE YOUR SKILLS AND WORK EXPERIENCE: __________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

12. EMPLOYMENT HISTORY AT BWS: (List in reverse chronological order)

Employment Duties/Responsibilities
Position Held Department Supervisor Dates performed
(From/To)

Form: BWS-App-V2012-07
 BELIZE WATER SERVICES LIMITED

13. EMPLOYMENT HISTORY WITH OTHER EMPLOYERS: (List in reverse chronological order)
Employment
Employer Name Address Position held Dates (From/To)

14. REASON FOR LEAVING/OR WANTING TO LEAVE YOUR LAST/CURRENT EMPLOYMENT:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

15. REFERENCE: (List at least three)

Work or
Name Home Address or Place of Work Phone No Personal?

16. OTHER RELEVANT INFORMATION: ____________________________________________________

_________________________________________________________________________________________

I certify that all of the information provided above is true and correct and that I have included all
relevant employment history.

Signature of Applicant: ____________________________

Form: BWS-InternalApp-V2014-09