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APPLICATION FOR EMPLOYMENT
Vulex. Inc. is an equal opportunity employer. As such, employment decisions for applicants and employees are made without regard to race. color, religion, sex, age (if over 40), national origin or disability (if able to perfonn the essential functions of the job with or without the aid of a reasonable accommodation) or any olher status protected under local, state or federal law. If you require assistance in completing this application. please inform the Human Resources Department
PERSONAL INFORMATION
NAME
*
First
Middle
Last
SOCIAL SECURITY #
*
Please enter your social security number, proof of U.S. Citizenship/Card holder #
ADDRESS
*
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
PHONE
Primary phone number
ALTERNATE PHONE
Secondary phone
EMAIL
*
Information submitted is used for hiring consideration only.
REFERRALS
Newspaper
Employment Agency
Alamo Work Source
How did you hear about this position ?
OTHER
Who.
AUTHORIZATION
*
Yes
No
Are you legally authorized to work in the united states?(Proof of eligiability will be requested upon offer of employment)
RESIGNATIONS
Yes
No
Have you ever been fired or asked asked to resig from a job?
IF YES.
Please explain why.
TRAVEL OPTION
Yes
No
Are you willing to travel for work?
OVERTIME
Yes
No
Are you willing to work overtime?
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EMPLOYMENT DESIRED
POSITION
What job position are you looking for
DATE/TIME
Date
Time
Date you can start?
SALARY
What is your desired salary
HAVE YOU EVER BEEN EMPLOYED BY THIS COMPANY BEFORE?
Yes
No
If yes please explain below.
WHERE & WHEN?
HAVE YOU EVER APPLIED TO THEH COMPANY BEFORE?
Yes
No
If yes please explain below.
WHERE & WHEN?
RELATIVES
Yes
No
Do you have any relatives currently employed with vutex?
WHO?
If yes, who?
CONVICTIONS & MISDEAMENORS
*
Yes
No
Have you ever been convicted of, plead guilty to, or received deferred adjudication for a felony or misdeamenor?
IF YES.
Please descrive. (Note: A positive response may not disqualify you, but a false statement will.)
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EDUCATION
HIGH SCHOOL
Name of high school you attended
YEARS ATTENDED
DID YOU GRADUATE?
Yes
No
COLLEGE
Name of college you attended
YEARS ATTENDED
DID YOU GRADUATE?
Yes
No
CERTEIFICATIONS
Diplomas, Certificates, Degrees, ect. not mentiond above
ADDITIONAL
List of additional educational and/or professional achievements.
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EMPLOYMENT
List below the last three employers, starting with the lastone first.
NAME AND ADDRESS OF COMPANY
DATE EMPLOYED
TO
JOB TITLE
SALARY
FULL/PART TIME
Full Time
Part Time
SUPERVISOR/MANAGER NAME
JOB DUTIES
REASON FOR LEAVING
__
NAME AND ADDRESS OF COMPANY
DATE EMPLOYED
TO
JOB TITLE
SALARY
FULL/PART TIME
Full Time
Part Time
SUPERVISOR/MANAGER NAME
JOB DUTIES
REASON FOR LEAVING
__
NAME AND ADDRESS OF COMPANY
DATE EMPLOYED
TO
JOB TITLE
SALARY
FULL/PART TIME
Full Time
Part Time
SUPERVISOR/MANAGER NAME
JOB DUTIES
REASON FOR LEAVING
MAY WE CONTACT YOUR FORMER EMPLOYERS?
Yes
No
PRESENT EMPLOYER?
Yes
No
JOB RESUME
Click or drag a file to this area to upload.
Please upload your job resume here. (Allowed File Extensions: .doc,.docx, .xls, .ppt, .pdf)
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REFERENCES
Give the name of three persons not related to you, whom you have known at least one year
NAME
*
BUSINESS
YEARS ACQUAINTED
ADDRESS AND PHONE NUMBER
__
NAME
BUSINESS
YEARS ACQUAINTED
ADDRESS AND PHONE NUMBER
__
NAME
BUSINESS
YEARS ACQUAINTED
ADDRESS AND PHONE NUMBER
AKNOWLEDGMENT
I hereby certify that the information provided by me in this application (or information on any other accompanying or required documents) is true, correct and complete to the best of my knowledge and I understand that any false statement or omission may be considered sufficient cause for rejection of this application or for dismissal from employment regardless of the timing or circumstances of discovery. I hereby authorize the Company to conduct physical exams as allowed by the Americans with Disabilities Act of 1990. I authorize the Company to request any persons, firms or corporations identified as a former employer or reference to answer any and all questions that may be asked and to give any and all information concerning me, including but not limited to, my work habits, disciplinary records, attendance records, character, or skill that may be sought in connection with this application. I expressly release these persons from any and all liability in fumishing responses to these inquiries. I also authorize the Company to conduct drug testing and background investigation as required. I understand and agree that, if employed, my employment is for no definite period and that I may be terminated at any time without any prior notice, regardless of the date of payment of my wages or salary. Ifthis application is considered favorably, I agree to abide by and comply with all rules and regulations of the Company as they currently exist and/or as they are modified from time to time during my employment relationshp.
NOTE
This application will be active for 90 days from this date. To be considered for any job after that time, you will need to complete another application form.
APPLICANT'S SIGNATURE
*
DATE
*
Date
Time
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