Employment #2 – Bell County Glass

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Employment #2

Job Openings

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Job Application

Job Application

Date *

Desired Position *

Desired Salary *

First Name *

Last Name *

Middle Name

City *

State *

Zip Code

Telephone *

Email *

Have you ever worked for Bell County Glass Co., Inc.? *

Yes

No

If so, when? *

How did you learn about us? *

Advertisment

Friend

Walk-in

Other

Other *

Please list any friends employeed by Bell County Glass Co., Inc. *

Are you over 18 years of age? *

Yes

No

Did you receive a copy of the job description for the position?? *

Yes

No

Are you physically or otherwise unable to perfom the duties of the job for which you are applying? *

Yes

No

If yes, please describe (Answering is voluntary and answers will be kept confidential)

Are you currently employed? *

Yes

No

Are you legally authorized to work in the US? (Proof of identity and work authorization will be required upon employment) *

Yes

No

On what date would you be available for work? *

Availability *

Full-time

Part-time

Shift work

Temporary

Can you travel if a job requires it? *

Yes

No

Additional relevent information

Education

High School *

Did you graduate?

Yes

No

Current Certifications/License Held

City/Statel *

Degree? *

College Name *

Did you graduate?

Yes

No

City/State

Degree/Major

Other Education Name *

Did you graduate?

Yes

No

City/State

Degree/Major

Employment History

Start with your present or last job. You may also include any activities which you believe demonstrate your qualifications for the position applied. "See Resume" is not acceptable.

Current or most recent employer *

Previous Employer Name *

Address *

Telephone *

Supervisor *

Position *

Ending Salary *

Starting Salary *

Start date of employment *

End date of employment *

Reason for leaving *

Duties *

Next previous employer *

Previous Employer Name *

Address *

Telephone *

Supervisor *

Position *

Ending Salary *

Starting Salary *

Start date of employment *

End date of employment *

Reason for leaving *

Duties *

Next next previous employer *

Previous Employer Name *

Address *

Telephone *

Supervisor *

Position *

Ending Salary *

Starting Salary *

Start date of employment *

End date of employment *

Reason for leaving *

Duties *

References

Name only those persons who are familiar with your work capabilities. Do not list relatives.

#1 Reference Name *

Phone *

Company *

Relationship *

Position *

Years known *

#2 Reference Name *

Phone *

Company *

Relationship *

Position *

Years known *

By sending this application I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 180 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at this time. I understand that I may be required to successfully complete a pre-employment physical examination conducted by a company-authorized physician and that I may be required to successfully pass a pre-employment drug/alcohol screening after I accept a conditional offer of employment.

#3 Reference Name *

Phone *

Company *

Relationship *

Position *

Years known *

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Bell county Glass co., Inc.

4801 Roy J. Smith Dr.

Killeen, TX 76543

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Mail: adminstrator@bellglass.net

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