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    Position you are applying for

    Desired Hourly Pay Rate

    Date available to start work


    PERSONAL INFORMATION

    First Name

    Middle Name

    Last Name

    Address

    City

    State

    Zip Code

    Cell Phone

    Email


    EDUCATION

    School Name

    Location

    Other Training, Certifications, or Licenses Held


    EMPLOYMENT HISTORY

    Employer Business Name

    Start Date

    End Date

    Work Phone


    REFERENCES

    Reference Name

    Reference Phone


    ACKNOWLEDGEMENT AND AUTHORIZATION

    Please check all that apply:

    I certify that all answers given herein are true and complete to the best of my knowledge.

    I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

    In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge.


    AUTHORIZATION

    Are you a US citizen?

    YesNo

    Do you currently have an active Texas Driver's License?

    YesNo

    Have you ever been convicted of a felony?

    YesNo

    If selected for employment are you willing to submit to a pre-employment drug screening test?

    YesNo