2023

Applicant Information

Full Name: De la cruz disla Jack Michael Date:12-30-1982

Last First M.I.

Address: Camino al medio Street #32

Street Address Apartment/Unit #

San Francisco de macoris Duarte 31000

City State ZIP Code

Phone: 829 337 6644 Email Jack301282@gmail.com

Education
High School: UASD Address:Manolo Tavares avenue

YES NO
From: 2016 To:2017 Did you graduate? Diploma:

College: Juan Pablo Duarte High School Address:El ciruello Street

YES NO
From: 2004 To:2009 Did you graduate? Degree:

Other: Address:_______________________________________________

YES NO
From: To: Did you graduate? Degree:

References
Please list professional references.

Full Name: La Sirena Grupo Ramos Relationship:Employer

Company: Grupo Ramos Phone:809 290 3000
Address: Manolo Tavares avenue

Full Name: Juan luis Garcia Relationship:Employer

Company: Ferreteria Gama Phone:809 588 2178
Address: Caonabo street, El Ciruelillo

Full Name: Relationship:

Company: Phone:
Address:

1
 Previous Employment

Company: La Sirena Phone:809 290 3000

Address: Manolo Tavares avenue, san Francisco de macoris Supervisor:Wandys Estevez

Job Title: Assintant store

Responsibilities: Helping people to find out what they need

From: 2007 To:20018 Reason for Leaving:To increase my income

Company: Phone:
Address: Supervisor:

Job Title:

Responsibilities:

From: To: Reason for Leaving:

Company: Phone:
Address: Supervisor:

Job Title:

Responsibilities:

From: To: Reason for Leaving:

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or
interview may result in my release.

Signature: Jack Michael De La Cruz Disla Date:04-29- 2023