Employment with TexDoor

Personal Information

Name *

First Last

Middle initial

Date *

MM / DD / YYYY

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Cell Phone Number *

### - ### - ####

Home Phone Number

### - ### - ####

Email

Date available

MM / DD / YYYY

Desired salary

Any physical limitations we should be aware of?

Position applied for *

*

Full time

Part time

Summer

Select all that apply

Date available for work

MM / DD / YYYY

Are you a citizen of the United States? *

Yes

No

Are you eligible to work in the United States? *

Yes

No

Have you ever worked for this company?

Yes

No

If so, when?

MM / DD / YYYY

Have you ever pleaded guilty to, been convicted of, received deferred adjudication, or probation for any criminal act? *

Yes

No

If yes, please explain (include date, type of offense, and location):

A conviction record will not necessarily disqualify you from employment

EDUCATION:

High School *

Did you graduate? *

Yes

No

Applicable subjects studied:

From

MM / DD / YYYY

To

MM / DD / YYYY

Address

University

Did you graduate?

Yes

No

Applicable subjects studied:

From

MM / DD / YYYY

To

MM / DD / YYYY

Other

Did you graduate?

Yes

No

Applicable subjects studied:

From

MM / DD / YYYY

To

MM / DD / YYYY

EMPLOYMENT HISTORY:

Company:

Phone Number

### - ### - ####

Address:

Supervisor:

Job Title:

Starting Salary

ending Salary

From

MM / DD / YYYY

To

MM / DD / YYYY

Reason for leaving:

May we contact your previous supervisor for a reference?

Yes

No

Company:

Phone Number

### - ### - ####

Address:

Supervisor:

Job Title:

Starting salary

Input hourly wage, if not salaried.

Ending salary

Input hourly wage, if not salaried.

From

MM / DD / YYYY

To

MM / DD / YYYY

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

No

Company:

Phone Number

### - ### - ####

Address:

Supervisor:

Job Title:

Starting salary

Input hourly wage, if not salaried.

Ending salary

Input hourly wage, if not salaried.

From

MM / DD / YYYY

To

MM / DD / YYYY

Reason for Leaving:

May we contact your previous supervisor for a reference?

Yes

No

Driving Record

Do you have a current Texas drivers license? *

Yes

No

Have you had any tickets in the last 5 years? *

Yes

No

Have you had any accidents in the last 5 years? *

Yes

No

References:

Please list three professional references

Full Name: *

Relationship

Company

Phone *

Address

Full Name: *

Relationship

Company

Phone *

Address

Full Name: *

Relationship

Company

Phone *

Address

Resume (optional)

I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or, if hired, termination.

I understand that as a condition of employment I will be required to provide legal proof of authorization to work in the U.S. I authorize the investigation of all statements contained herein and the references listed above to give you and and all information concerning any previous employment and any pertinent information they might have, personal or otherwise, and release all parties from all liability for any damages that may result from furnishing same on you.

I understand and agree that, if hired, my employment is for no defined period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice. New applicants will be subject to a pre-employment drug screen. By signing this application for employment you accept this requirement.

Fee for drug screen to be paid for by applicant if test results come back positive or if applicant is employed by Texdoor LTD. for less than 10 working days.

Do you agree with the terms and conditions? *

Yes, I agree.

Signature *

Date *

MM / DD / YYYY