In addition to this application, please submit your resume

and cover letter using one of the methods listed below.

Indicate the position you are applying to.

Human Resources Department at CentroNía:

1420 Columbia Road, NW, DC 20009
[email protected]
Fax: 202-745-0154

EMPLOYMENT APPLICATION
Last Name First Name Middle Initial
Salgado Ariana P
Street Address City/State Zip Code Phone Number
850 Quincy St NW DC 20011 7874554038
Email [email protected]
Are you authorized to work in the U.S? Yes No Will you now or in the future require
sponsorship for employment visa
status (e.g. H-1B visa status)?
Yes No
Position Desired: Can you perform the duties of the job
Admissions Specialist you’re applying for: Yes No
Wage/Salary Desired: Where did you find out about this job
opportunity?
38-40k Indeed
Have you ever been convicted of a felony, or a misdemeanor involving any violent act, use or
possession of a weapon, or act of dishonesty for which the record has not been sealed or expunged, or
do you have such a case pending? A conviction will not necessarily disqualify you for employment.
Yes No If Yes, When? & Where? Please Explain:

Have you ever worked for this organization? Yes No If so, when?
Last summer as a volunteer.

EDUCATION
Guaynabo,PR
Academia San Jose HS Address: ______________________________________
High School: ___________________________________
Did you graduate? Yes No High School Diploma
Degree: ____________________________________________________
Manhattanville College
College: _______________________________________ 2900 Purchase St. Purchase
Address: ______________________________________ NY
Did you graduate? Yes No B.S. in International Business Management
Degree: ____________________________________________________
Other: _________________________________________ Address: ______________________________________
Did you graduate? Yes No Degree: ____________________________________________________

PROFESSIONAL REFERENCES
Claudia Colon Former Employer
Name & Company: ________________________ Relationship: _______________________________________
[email protected]
Phone Number: ___________________________ Email (Preferred): __________________________________
Matthew Pauley
Name & Company: ________________________ Professor
Relationship: _______________________________________
Phone Number: ___________________________ Email (Preferred): [email protected]
__________________________________
Randy
Name & Company: ________________________ Former supervisor
Relationship: _______________________________________
[email protected]
Phone Number: ___________________________ Email (Preferred): __________________________________
 1

EMPLOYMENT HISTORY # 1

Name of Employer: _____________________________ Job Title: ___________________________________

City: __________________________ State: _________________________ Zip Code: ______________________
Dates of Employment – From: ____________________________ To: __________________________________
Starting Salary: __________ Ending Salary: _________ Reason for Leaving: ___________________________
Supervisor: ___________________Telephone: ___________________ Email Address: ____________________
May we contact your previous employer: Yes No

EMPLOYMENT HISTORY # 2

Name of Employer: _____________________________ Job Title: ___________________________________

City: __________________________ State: _________________________ Zip Code: ______________________
Dates of Employment – From: ___________________________ To: ___________________________________
Starting Salary: __________ Ending Salary: _________ Reason for Leaving: ___________________________
Supervisor: ___________________Telephone: ___________________ Email Address: ____________________
May we contact your previous employer: Yes No

EMPLOYMENT HISTORY # 3

Name of Employer: _____________________________ Job Title: ___________________________________

City: __________________________ State: _________________________ Zip Code: ______________________
Date of Employment – From: ____________________________ To: ___________________________________
Starting Salary: __________ Ending Salary: _________ Reason for Leaving: ___________________________
Supervisor: ___________________Telephone: ___________________ Email Address: ____________________
May we contact your previous employer: Yes No
Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. In connection with my
application for employment, I understand and agree that background inquires may be requested by
CentroNía or on the behalf of CentroNía that will seek information as to my character, work habits,
including oral assessments of my job performance, experiences and abilities, along with reasons for
termination of past employment. Furthermore, I understand and agree that CentroNía may request
information from various federal, state, and other agencies, including public and private sources which
maintain records concerning my past activities relating to my criminal record in order to comply with
the Child and Youth, Safety and Health Omnibus Emergency Amendment Act of 2003.

If this application leads to employment, I understand that false or misleading information in my

application or interview may result in my release.

Signature: __________________________________ Date: _______________________________

CentroNía is an Equal Opportunity Employer.