TSE Employment Application

This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. This application applies only to the position specified. It is considered inactive after 60 days. If at any time after this point you wish to be considered for employment with this company, another application will have to be completed. We are an Equal Employment Opportunity employer, and do not discriminate in our hiring or employment practices. All qualified applicants will receive consideration without regard to race, color, creed, religion, national origin, citizenship, age, disability, sex, marital status, sexual orientation, or any other characteristic protected by Local, State or Federal law.

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Name *

First

Last

Middle Initial

Email *

Today's Date

Enter date as YYYY/MM/DD

Street Address

City

State

Zip

Phone

Cell Phone

How long have you lived at this address?

Position Applied For

Date Available

Enter date as YYYY/MM/DD

Can you work any day of the week or shift required?

Do you have the legal right to remain and work in the United States?

• Yes
• No

After an offer of employment has been made, can you submit proof of citizenship or legal entry into country?

• Yes
• No

the Address

Have you ever worked for TSE before?

• Yes
• No

If so, when?

How did you learn about this position and why are you interested in working here?

If referred by a current TSE employee, state name here:

All positions at TSE require you to drive. Do you have the appropriate driver’s license?

• Yes
• No

Have you had any moving violations in the past 5 years?

• Yes
• No

If “Yes” please describe

Please list any other skills, licenses or certificates that may be job-related or that you feel would be of value to this job or our organization.

EMPLOYMENT HISTORY

Company 1

Phone number

Address

Supervisor

Job Title

Please describe your responsibilities.

Date Start

Enter date as YYYY/MM/DD

Date End or Enter 'Still Employed'

Enter date as YYYY/MM/DD

Reason For Leaving

May we contact your present employer for verification?

• Yes
• No

Company 2

Phone number

Address

Supervisor

Job Title

Please describe your responsibilities

Date Start

Enter date as YYYY/MM/DD

Date End or Enter 'Still Employed'

Enter date as YYYY/MM/DD

Reason For Leaving

May we contact your present employer for verification?

• Yes
• No

Company 3

Phone number

Address

Supervisor

Job Title

Please describe your responsibilities

Date Start

Enter date as YYYY/MM/DD

Date End or Enter 'Still Employed'

Enter date as YYYY/MM/DD

Reason For Leaving

May we contact your present employer for verification?

• Yes
• No

EDUCATION

High School

School Address

DId you graduate

• Yes
• No

College

School Address

Did you graduate?

• Yes
• No

Degree

Other

School Address

Degree

Did you graduate?

• Yes
• No

Are you currently attending school now?

• Yes
• No

If Yes where?

School name

REFERENCES

1) Name/ Email Address/Phone/ Years Known/Relationship

2)Name/ Email Address/Phone/ Years Known/Relationship (copy)

3) Name/ Email Address/Phone/ Years Known/Relationship (copy) (copy)

DISCLAIMER AND SIGNATURE

Paragraph TextI certify the answers given by me to the foregoing questions and any statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentations of facts regarding information in this application may result in rejection of my application, or discharge at any time during my employment. I also agree that, if company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment. I understand that if I am hired, my employment will be “at-will”, and that either the Company or I can choose to terminate the employment relationship for any reason, or no reason at all, with or without notice. I understand that background, drug, or medical testing may be conducted on me as part of the process to determine my fitness for employment, and hereby agree to submit to such testing. I authorize all persons, schools, companies, medical practitioners, current and/or former employers, and law enforcement authorities to release any information concerning my background or test results, and hereby release any said persons, schools, medical practitioners, current and/or former employers, and law enforcement authorities from any liability for any damage whatsoever for issuing this information.

Applicant’s Full Name (please print)

Date

Enter date as YYYY/MM/DD

Submit

I certify the answers given by me to the foregoing questions and any statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentations of facts regarding information in this application may result in rejection of my application, or discharge at any time during my employment. I also agree that, if company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment. I understand that if I am hired, my employment will be “at-will”, and that either the Company or I can choose to terminate the employment relationship for any reason, or no reason at all, with or without notice. I understand that background, drug, or medical testing may be conducted on me as part of the process to determine my fitness for employment, and hereby agree to submit to such testing. I authorize all persons, schools, companies, medical practitioners, current and/or former employers, and law enforcement authorities to release any information concerning my background or test results, and hereby release any said persons, schools, medical practitioners, current and/or former employers, and law enforcement authorities from any liability for any damage whatsoever for issuing this information.