Employment Application

Position Applying For*
Name*
First Middle Last
Home Phone
Cell Phone*
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Permanent Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Driver's License Number*
Issuing State*
Do you have a CDL?*
- Yes
- No
Moving Violations? If so, explain.
Are you 18 years of age?*
- Yes
- No
Have you been convicted of a felony in the last 7 years? If so, explain.
Did you serve in the military? If so, what was your branch and final rank?
Do you have any special skills you want us to know about?
Are you eligible to work in the United States?*
- Yes
- No
Name of your last employer
First Last
Type of Work
Date Started
MM slash DD slash YYYY
Date Ended
MM slash DD slash YYYY
Reason for leaving
Location of your last employer
Job Title
Ending Pay Rate
Phone Number of your Last Employer
Name of your next most recent employer
First Last
Type of Work
Date Started
MM slash DD slash YYYY
Date Ended
MM slash DD slash YYYY
Reason for leaving
Location of employer
Job Title
Ending Pay Rate
Phone Number of Employer
Name of your next most recent employer
First Last
Type of Work
Date Started
MM slash DD slash YYYY
Date Ended
MM slash DD slash YYYY
Reason for leaving
Location of employer
Job Title
Ending Pay Rate
Phone Number of Employer
Name of your High School?
Location
Received Diploma?
- Yes
- No
College Attended (if applicable)
Approximate Graduation Date (if applicable)
Area of Study
Trade/Tech Schools attended (if applicable)
Location
Approximate Dates attended
Area of Study/Diploma
Post Graduate Institutions attended (if applicable)
Location
Approximate Dates Attended?
Area of Study/Diploma
Professional Reference Name
First Last
Reference Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Reference Phone
Professional Reference Name
First Last
Reference Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Reference Phone
Professional Reference Name
First Last
Reference Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship
Reference Phone
File
Max. file size: 50 MB.
Notice*
Electronic Signature Required
The Food Bank maintains a Drug-Free & Alcohol Free Work Environment. As part of our procedure for processing your employment application, your references may be checked; the South Plains Food Bank will also request an investigative reporting agency report. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. The State of Texas is an employment at-will state; therefore employment at the South Plains Food Bank is voluntarily entered into and the employee is free to resign at will at any time, with or without cause, and with or without notice. Similarly, the South Plains Food Bank may terminate the employment relationship at any time, with or without notice or cause, so long as there is no violation of applicable state and federal law.
This document is not intended to, nor does it create a contract of employment. It will be retained for 45 days. By signing, I authorize, understand and agree to the information disclosed in this application.

Employment Application

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