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Name / Nombre
Email / Dirección de Correo Electrónico
Phone / Numéro
Address / Dirección
Address Line 2 / Adicional
City / Ciudad
State / Estado
Zip Code / Código Postal
Requested Work / Trabajo Solicitado
Full Time / Tiempo Completo
Part Time / Tiempo Parcial
Days Available / Días Disponibles
Check all that apply / Marque todo lo que corresponda
Monday / Lunes
Tuesday / Martes
Wednesday / Miércoles
Thursday / Jueves
Friday / Viernes
Saturday / Sábado
Sunday / Domingo
Time Preffered / Prefernce Tiempo
Day / Día
Night / Noche
Residential Status / Estado Residencial
US Citizen / Ciudadano Estadounidense
Resident / Residente
Immigrant here on work visa / Inmigrante Qquí en la Visa de Trabajo
Additional Information You Wish To Provide /Información Adicional Desea Proporciona
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