* = Required Information
PERSONAL INFORMATION
Yes No
Female Male
(If no, hire is subject to verification that you are of legal age to work)
Yes No
Yes No
Yes No
EDUCATION/SKILLS
Yes No
Yes No
PROFESSIONAL LICENSES AND OR CERTIFICATES
EMPLOYMENT RECORDS
Yes No
Yes No
EMPLOYMENT HISTORY
Please provide 3 current employment histories.
Female Male
REFERENCES
Give the names of three people not related to you, whom you have known at Least one year.
TRANSPORTATION:
The following section must be completed if you are applying for a position which Requires the operation of a motor vehicle, owned or released by the company, or if you must use your own vehicle for company purposes.
Yes No
If yes, give name of insurance company And expiration date:
Yes No
If yes, give date(s) and the severity of the incident (s)
TRAFFIC VIOLATIONS RECORD:
List the traffic citations that you have received during five (5) years preceding date of this Application, and state the disposition of each, as "dismissed", "paid fine", "defensive driving", etc.
NOTE: If you are hired for a position that requires driving, you must keep us informed of Any changes in your driving record.
Employers in Texas have a legal in regard to each employee's safety. You, your fellow worker's and our client's is of the utmost importance. It is not beneficial for you or us, as your employer, to place you into a job where you have a higher risk of injury because of a physical or mental condition. In addition to our own requirement, the Americans with Disabilities act also requires us make certain that each employee is Capable of performing the essential functions of the job. Therefore, you must be honest with us in regard to your personal evaluation as to your anilities to perform the essential Functions described in the job description. As an equal Opportunity Employer, we Consider applicants for the employment regardless of their disabilities, therefore if you Are unable to perform the essential function of the job, we welcome you to discuss any Needs for the accommodations that would allow you to perform the job in accordance With job description.
Yes No
CERTIFY EMPLOYMENT INFORMATION
I certify that all information given on this application is true, correct and complete to the best of my knowledge. I also certify that I have accounted for all of my work experience and training on this application, and I have not knowingly withheld any fact or circumstance, which would of disclosed, after my application unfavorably. Four J's Service is hereby authorized to make any investigation of my employment, educational, credit or criminal history through any investigative agencies or bureaus of its choice. I release all relevant parties from all liability of any damages resulting from furnishing such information. I understand that I must be capable of performing the essential functions of the job for which I am applying. I understand that my employment is subject to the completion of the Medical Examination and Mobility Evaluation and I understand that my employment may be conditioned upon maintaining a favorable health evaluation and drug/alcohol screening. I also agree that all information concerning said physical examination can be supplied to the authorized agent of this company, upon request. If employed by Four J's services, I agree to abide by its rules and regulations. I Understand discovery of misrepresentation or omission of facts herein will cause for immediate dismissal I authorized any inquiry to be made on any required completing my Employment file. I understand that operating conditions may require me to temporarily Works shifts other than the one for which I am applying and I agree to such scheduling Changes as directed by my supervisor. I further understand that this application for employment and that no employment Contract, either express or implied, is being offered. I have supplied a copy of the job Description and I have read and understand the essential functions of the job. I also Understand that if employed such employment if for an indefinite period and can be Terminated at will by either party, with or without notice, at any time, for any or no Reason, and is subject to change in wages, conditions, benefits, and operating policies. If employed, I will be required to complete an employment verification form ( 1-9 ) and Within three days show satisfactory evidence of identity and eligibility for employment.
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