How did you hear about the position for which you are applying? * General Information EQUAL OPPORTUNITY EMPLOYER. It is our policy to abide by all federal, state and local laws prohibiting employment discrimination based solely on a person's race, color, religious creed, sex, national origin, ancestry, citizenship status, pregnancy, childbirth, physical disability, mental disability, age, military status or status as a Vietnam-era or special disabled veteran, marital status, registered domestic partner or civil union status, gender (including sex stereotyping and gender identity or expression), medical condition (including, but not limited to, cancer related or HIV/AIDS related), genetic information, sexual orientation, or any other protected status except where a reasonable, bona fide occupational qualification exists. Name *
Current Mailing Address
* Preferred location: * -- Please select -- Houston Dallas / Fort Worth Austin Corpus Christi College Station Victoria Position for which you are applying: Position for which you are applying: Position for which you are applying: Position for which you are applying: Position for which you are applying: Date available for work Month 1 2 3 4 5 6 7 8 9 10 11 12 Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Check the following options you would consider: Are you subject to any type of agreement with a current or former employer or entity that would restrict your ability to work at our company (e.g. non-compete, confidentiality, non-disclosure)? * Please explain and provide a copy of such agreement: Education & Training Please select all educational experience you possess:
*Only list college or universities accredited by the Department of Education (DOE). The DOE maintains a database of accredited institutions at
High School Education High School Degree Received
GED Education GED Degree Received
College Education College Degree Received?
Graduate School Education Graduate School Degree Received
Trade School Education Trade School Degree Received Please list course work undertaken or degree/diploma received from an unaccredited college, as well as any other education, training, special or skills that you possess related to the job:
Professional Licenses / Certifications Please list any Professional Licenses / Certifications you posses related to the job: Please list any machines, equipment, or software programs on which you are qualified and experienced in operating: Are you applying for a position which involved driving a motor vehicle in the course and scope of the employment duties? * Do you have a valid driver's license in this state? * Can you, after employement, submit verification of your legal right to work in the United States? * Are you 16 years of age or older? * Please select one of the following: * Were you previously employed at our company? * Can you perform the essential functions of the job? * Do you have any relatives working for our company? Employment History
Please list all work experience beginning with the present or most recent job.
Employment History 1 Address
May we contact? Type of Employment Brief Description of Duties
Employment History 2 Address
May we contact? Type of Employment Brief Description of Duties
Employment History 3 Address
May we contact? Type of Employment Brief Description of Duties Criminal Record Information
Instructions for answering the next two questions below:
All Applicants. Do not include convictions that were sealed, eradicated, erased, annulled by a court, expunged, pardoned, or deferred and withdrawn.
District of Columbia, Illinois, and Rhode Island Applicants. Do not respond to the second question (regarding pending charges).
California Applicants. Do not include: a misdemeanor conviction for possession or transportation of a small amount of marijuana (28.5 grams or less) if the conviction is more than two (2) years old; participation in any pretrial or post trial diversion program for drug or alcohol rehabilitation; or a misdemeanor conviction for which probation was successfully completed or otherwise discharged and the case was judicially dismissed.
Colorado Applicants. Exclude information involving any record of civil or military disobedience unless such matters resulted in a plea of guilty or a conviction by a court of competent jurisdiction.
Connecticut Applicants. You are not required to disclose the existence of any arrest, criminal charge, or conviction, the records of which have been erased. Criminal records subject to erasure are: records pertaining to a finding of delinquency or the fact that a child was a member of a family with service needs; an adjudication as a youthful offender; a criminal charge that has been dismissed or nulled (not prosecuted); a criminal charge for which the person was found not guilty; or a conviction for which the offender received an absolute pardon. Any person whose criminal records have been erased is deemed to have never been arrested within the meaning of the law as it applies to the particular proceedings that have been erased, and may so swear under oath.
Hawaii Applicants. Do not answer the following two questions.
Massachusetts Applicants. Do not answer the following two questions.
Michigan Applicants. Regarding pending charges, limit your response to felony offenses.
City of Philadelphia (Pennsylvania) Applicants. Do not respond to the first question (regarding convictions/pleas).
Utah Applicants. Regarding convictions, limit your response to felony convictions. Do not respond to the second question (regarding pending charges). 1. Convictions / Pleas. *
In the past ten (10) years, have you ever been convicted of, or pled guilty or no contest to, any criminal offense other than any applicable exceptions listed above?
2. Pending Charges *
Have you ever been arrested for any matters for which you are now out on bail or on your own recognizance pending trial?
If you answered Yes to either of the above two questions, please provide the date(s) and describe that criminal record so the individual circumstances can be considered.
Criminal convictions or arrests will not automatically disqualify an applicant from employment. Business References
Please list three individuals, in addition to listed employment references, known to you for at least three years
Please include any other information you think would be helpful to us in considering you for employment, such as additional work experience, articles/books published, activities, honors received, etc. You may omit all information that would indicate age, sex, sexual orientation, race, religion, color, national origin, or disability.
Consent Please read the following statement carefully: *
I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I also agree that falsification or significant omission of information requested in this application or in the application process may disqualify me from further consideration for employment and may be considered justification for dismissal if discovered at a later date.
I authorize all persons listed above (and on the accompanying resume, if any) to give employer and/or any service providers any and all information concerning my previous employment and education and any pertinent information they may have, personal or otherwise, and release all parties, such persons and employer and/or any service providers, from liability for any damage that may result from furnishing same to employer and/or any service providers.
I understand that employer will provide workers' compensation insurance coverage for its employees. In the event of an injury in the workplace, I agree that my sole remedy lies in coverage under employer's workers' compensation insurance policy.
If employed by employer, I agree to abide by the policies and procedures of employer. I further understand that my employment can be terminated, with or without cause or notice, at any time, at the discretion of employer or myself.
I understand that employer may obtain a consumer and/or investigative consumer report for employment purposes that may include information regarding prior employment, work experience and performance, reasons for employment termination, and information as to character, general reputation, personal characteristics, or mode of living. The report may also contain a records check of driving, criminal, credit, education, degrees, professional licenses and/or certification records depending on the position. By signing this application, I authorize the procurement of a consumer and/or investigative consumer report by employer and/or any service providers as part of the pre-employment background investigation and if hired, at any time during my employment. California Applicants: I further understand that employer and/or any service providers may obtain Public Records about me as part of an internal background investigation and that I may waive my right to receive a copy of such Public Records by checking this box.
UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.
I understand and agree that, subject to applicable law, I may be required to take a drug and alcohol screening test. I hereby give my voluntary consent for a blood and/or urine sample to be collected from me and submitted for testing. I also consent to the release of the test results to employer and/or any service providers. I understand that any positive drug or alcohol result may preclude my employment. I understand and agree to the above statement. Date & Sign Date * Signature *
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