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Workers
First Name:
Middle Name:
Last Name:
Date of Birth:
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
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2005
2006
2007
2008
Country of Origin:
Nationality:
Country of Residence:
City:
Province/Department:
Age :
E-mail :
Phone:
Fax:
Studies:
-- Choose an Option --
Primary School
High School
Technical
College
Marital Status:
-- Choose an Option --
Single
Married
Divorced
Accompanied
Widower
Profession:
How many years has been workers, Dairy Hands, Ranch Hands or Fishermen for:
What kind of driver License do you have:
Country of the license:
How many years have had a license for:
How many years have driven for:
What do you drive now:
Do you have a car o a truck:
-- Choose an Option --
Yes
No
Languages:
English
Spanish
French
Italian
Portugues
German
Other Languages:
Do you have employees:
-- Choose an Option --
Yes
No
How many:
Do you have visited North America before as a tourist:
-- Choose an Option --
Yes
No
As a Worker:
-- Choose an Option --
Yes
No
In which year you visit North America:
How long you were in North America:
Which country in North America did you visit:
-- Choose an Option --
Mexico
Canada
Usa
Do you have children:
-- Choose an Option --
Yes
No
How many:
Do you have specific courses as a workers, dairy hands, ranch hands or fishermen:
-- Choose an Option --
Yes
No
Such as:
Have you worked outside of your country of residence before:
-- Choose an Option --
Yes
No
Where:
Which Year:
How long:
Do you have own computer:
-- Choose an Option --
Yes
No
Do you have experience in "supervision of other workers, dairy hands, ranch hands, fishermen":
-- Choose an Option --
Yes
No
Stature-meter(s):
Stature-centimeters:
Weight-kilos:
Do you smoke cigarettes:
-- Choose an Option --
Yes
No
What is its your favorite drink:
Do you have Mechanical Skills:
-- Choose an Option --
Yes
No
What is it the low temperature in your town during the winter-Centigrade:
Do you have updated passport:
-- Choose an Option --
Yes
No
Which country:
Would you be available to work outside up to 9 months per year away of your family, culture and country:
-- Choose an Option --
Yes
No
What is your favorite music:
Do you have family in America North:
-- Choose an Option --
Yes
No
Where:
-- Choose an Option --
Mexico
Canada
Usa
Are you allergic to something:
-- Choose an Option --
Yes
No
To What:
Do you have problems with its back:
-- Choose an Option --
Yes
No
Can you raise 50 kilos without problem:
-- Choose an Option --
Yes
No
What is your favorite food:
Do you like to hunt:
-- Choose an Option --
Yes
No
Do you like to fish:
-- Choose an Option --
Yes
No
Do you like "country and western" music:
-- Choose an Option --
Yes
No
How much would you like to make monthly in North America as a workers $:
If you are selected, are you ready to guarantee 3 years of working with the company:
-- Choose an Option --
Yes
No
Are you ready to accept the responsibility for your actions in relation to the work:
-- Choose an Option --
Yes
No
What would you like to ask:
Why do you think the Agriworkers.com should select you:
Thanks for your interest in Agriworkers.com. If this is a request for services we will contact you by e-mail shortly. If it was just a visit, thanks and come back and visit soon..