APPLICATION FOR EMPLOYMENT
CAMERON COUNTY
1100 E. Monroe St. Suite 118, Brownsville, Texas 78520
(956) 544-0827
Affirmative Action/Equal Employment Opportunity/MFD Employer
Answer all questions completely. Only fully completed applications will be considered for employment. The information you supply will
be fully verified, so you should avoid any misstatements since they would jeopardize your consideration for employment or serve as
grounds for dismissal.
PLEASE PRINT CLEARLY OR TYPE
Today’s Date:
Position Desired: ______________________
NAME: _____________________________________________________________________________________________________
(Last Name)
(First Name)
(Middle Initial)
Have you ever worked under another name?
No
Yes
If Yes, what name?
Contact Information: (Phone/Mobile/Pager)
Are you over 18 years of age?
No Yes
Date Available: ______________________________________
Hours willing to work:
Full Time
Part-Time
Rotating Shift
Temporary
Willing to travel?
No
Yes
Percent of Time:
How did you hear about the job?
Newspaper Advertisement
Cameron County Employee
County Bulletin Board
Texas Workforce Commission
School Placement Center
Texas Workforce Development Board
Other:
___________________________________________________________
__________________________________________________________________
PERSONAL DATA
Have you ever applied for a position with Cameron County? No
Yes
Give Date: _____________________________
Have you ever worked for Cameron County?
No
Yes
Dates, From: ___________________________
To: ___________________________
Are any of your relatives employees of Cameron County?
No
Yes
If yes, list name, relationship, and department employed in: ______________________________________________________________
______________________________________________________________________________________________________________
Have you ever been convicted of a felony, misdemeanor, or received a differed adjudication? (Disclosure of criminal record does not
automatically disqualify you for employment):
No
Yes
If yes, please explain dates, nature of charge, and disposition: ____________________________________________________________
______________________________________________________________________________________________________________
Are you authorized to work in this Country?
No
Yes
Have you ever been discharged, suspended, or asked to resign from employment? If Yes, Please explain: No
Yes
__________________________________________________________________________________
Are you a veteran of the U.S. Military Service? (This information needed for Civil Service credit) No
Yes
Type of Discharge: _____________
Dates: _________________
Are you able to perform the essential job functions with or without reasonable accommodation? (Answer only after reviewing the
essential job duties on the job posting; may request a copy of the job description)
No
Yes
__________________________________________________________________________________________