DECLARATION
Can you drive? *
YesNo
If Yes, please specify your driver's license number:
Do you have your own car? *
YesNo
Do you have any handicaps? *
YesNo
If Yes, please specify:
Do you suffer from chronic illness? *
YesNo
If Yes, please specify:
Have you ever been fired by any of your previous employers? *
YesNo
If Yes, please specify:
Have you ever been penalized by criminal or civil law? *
YesNo
If Yes, please specify: