Team Member Application

Please NOTE: while mobile phones are supported it is highly recommended to use a desktop browser to complete this application.

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

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?

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.)

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.

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)

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