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Application
TBI Employment Application
Step
1
of
6
16%
Position You're Applying For
Date of Application
Month
Day
Year
Referral Source
Advertisement
Friend
Relative
Other
Please describe other source
Your Personal Information
Your Name
(Required)
First
Middle
Last
Your Email
(Required)
Enter Email
Confirm Email
Address
Street Address
Address Line 2
City
State
ZIP Code
Your Phone
(Required)
Social Security Number
Texas Driver's License Number
Best Time To Call You
When is the best time for us to reach you via telephone?
Mornings
Early Afternoon
Late Afternoon
Early Evening
Emergency Contact
In case of emergency, you may contact the following person(s) at the phone & address below.
Previous Employment
Are You Employed Now?
Yes
No
May We Contact Your Current Employer?
Yes
No
Date Available for Work
Month
Day
Year
Have You Ever Been Employed Here Before?
Yes
No
Give Date of Your Last Employment Here
Month
Day
Year
Are Your Available To Work...
Full-Time
Part-Time
Temporary
Shift Work
Are You On a Lay-Off and Subject to Recall?
Yes
No
Have You Been Convicted Of A Felony Within The Last 7 Years?
Yes
No
Please Explain Your Conviction
Your Previous Employers
Please list your previous employers, the dates you worked and the position you held
Employer
Phone
Address
Dates Employed
Job Title
Hourly Rate/Salary
Supervisor Name
Reason for Leaving
Add
Remove
Education
Elementary (K-8)
Please list each school's name and years completed.
High School (9-12)
Please list each school's name and years completed.
College/University
Please list each school's name, years completed, and course of study.
Graduate/Professional
Please list each school's name, years completed, and course of study. Also describe any specialized training, apprenticeships, skills, and extra-curricular activities.
Your Skills and Qualifications
Summarize Special Skills and Qualifications Acquired From Employment or Other Experience
Are You A Veteran Of The U.S. Military Service?
Yes
No
What Branch Did You Serve Under?
Are You Willing To Abide By The Rules Of The TBI Drug & Alcohol Policy?
Yes
No
List Languages You Speak, Read, And/Or Write And Level of Knowledge
Have you been given a written job description for the job for which you are applying?
If you have not received a written job description, please ask the person from whom you received this application.
Yes
No
Physical Requirements
Are you capable of working outside for 9 hours per day, 5 days per week, in any weather conditions?
Yes
No
Can you accomplish all of the tasks required for the position you are applying for?
Yes
No
Can you perform the physical and mental requirements of the position you are applying for?
Yes
No
Can you work safely within the described environment and conditions described for the position you are applying for?
Yes
No
Can you travel to the distant job sites that may be required for the position you are applying for?
Yes
No
If your answer is no to any of the above, please explain in detail.
Agreements
At Our Request Would You Be Willing to Submit To A Polygraph Test And/Or Urinalysis For Matters Concerning Company Business Only.
Yes
No
Applicant's Statement
I certify that answers given herein are true and complete to the best of my knowledge, and that any additional resume sheets that I may have attached represent truthful information to be used in considering my application.
I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not and is not intended to be a contract of employment.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that my employment is an employment at will and that I am required to abide by all rules and regulations of the company, including but not limited to, the Company safety policy and Company alcohol and drug policy, which have been discussed thoroughly.
I agree with the above statement.
Signature
Date Signed
Month
Day
Year
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