EMPLOYEE APPLICATION


Position applying for: LFC Place:  
EMPLOYEE INFORMATION
Name:
Last   First Middle
             
Telephone:   Email:

Alternate

telephone:

             
Address:  
Are you able to perform the essential functions of 
the position with or without accommodations?
Yes  No  
       
If necessary for the job are you older than:
14  15  16  (Checkone) 
18  19   21   
 
I am legally eligible for employment in the U.S.?
Yes No
 
I am seeking a permanent position: Yes No 
 
I will be able to report to work
days after being notified I am hired.
If necessary for the job, Iamableto:
Workovertime? Yes No
Provide a valid Texas Driver's License?   Yes  No
 
If so, fill out the following:
  Issuing state:
Type:
 
Endorsement(s): Motorcycle    Passengers
  CDL     Tankers
  SchoolBus Double/Tripletrailers
     
Work the followingshifts:(checkallthatapply)
Any  Day Night  Swing Rotating
Split  Graveyard  Other:  
EMPLOYMENT HISTORY

    List most recent employment first. Include summer or temporary jobs. Be sure all your experience or employers related to this job are listed here, in the summary following this section or on an extrasheet of paper if necessary.No more than 10 years history
recommended.

Employer name and address:

Pay:    $

Per:      

Position title/duties,skills:

Supervisor:  

Telephone: 

Startdate: 

Enddate:     

Reasonforleaving:      

Employer name and address:

Pay:    $

Per:      

Position title/duties,skills:

Supervisor:  

Telephone: 

Startdate: 

Enddate:  

Reasonforleaving:

Employer name and address:

Pay:    $

Per:      

Position title/duties,skills:

Supervisor:  

Telephone: 

Startdate: 

Enddate:  

Reasonforleaving:       

Employer name and address:

Pay:    $

Per:      

Position title/duties,skills:

Supervisor:   

Telephone: 

Startdate: 

Enddate:     

Reasonforleaving:       

Summarize other employment related to this job:

Education




Highschool
College/university
Business/technical
Additional

Institutionname

Years

completed
Field of study Graduate or degree
Milatery

Are you a veteran?                     Yes                         No
Duty/specialized training



SKILLS & QUALIFICATIONS

Other qualifications such as special skills,abilities or honors that should be considered:

Types of computers,software,and other equipment you are qualified to operate or repair:

Professional licenses,certifications or registrations:


Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to
the employer's attention:

REFERENCES

List two personal references who are not relatives or former supervisors.                                                                               

Name

Address

Telephone

Occupation

Years known

 

Name

Address

Telephone

Occupation

Years known

   
CONTECT
In case of accident or illness,please contact: Name: Day time phone:
Address: Relationship:
INFORMATION TO THE APPLICANT
As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application,and are subsequently hired, you may be discharged from your job. You may make awritten requestforinformation derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/ or a drug test, or to sign a conflict of interest agreementand a bide by its terms. I understand and agree to the information shown above.
  Date 
Signature of Applicant  
EqualEmploymentOpportunity: While many employersare required by federal lawto have anAffirmative ActionProgram, all employers are required to provide equal employment opportunity and may ask your national origin, race and sex for planning and reporting purposesonly. This information is optional and failure to provide it will have no effect on your application for employment.