Texas Senate Application For Employment Page 2
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3Texas Senate
An Equal Opportunity Employer
APPLICATION FOR EMPLOYMENT
PLEASE TYPE OR PRINT IN BLACK INK AND ANSWER ALL QUESTIONS
Date:
Name, (Last, First, Middle)
Social Security Number
Current Address (Street & Number or P.O. Box, City, State, Zip Code)
Phone (Area Code and Number)
Permanent Address - If different from above (Street & Number or P.O. Box, City, State, Zip Code)
Alternate Phone #
Are you a U.S. Citizen?
Yes
No
If “No”, please specify your Visa/Immigration Status
Proof of your Citizenship/Visa/Immigration Status must be submitted upon request.
Driver’s Record if applying for position that requires use of State Vehicle
Driver’s License (State & No.)
Excellent
Good
Fair
Poor
Alternate Person to contact if you are unable to locate for Prospective Employment
Phone Number
Have you ever been convicted
Yes
No
If “Yes” Describe Location, Date and the Type of Conviction (Use extra paper if necessary)
*
of a felony by any court?
Are you related to any member of the Legislature or
If “Yes” List Names, Relationship and State Agency or Department
employee of the State of Texas?
Yes
No
Have you ever been employed
If “Yes” When?
What Department or Agency?
by the State of Texas?
Yes
No
How or by whom were you Referred to the Senate for Employment?
List Position you are
applying for:
1.
2.
3.
Minimum Acceptable Salary
Full Time
Part Time
Shift
Date available for Employment
What hours can you work?
Number of
Type of
Dates Attended
Graduated
Major Field
Sem. Hrs.
Diploma
Type of School
Name and Location of School
G. P. A.
of Study
NO
FROM
TO
YES
Completed
or Degree
High School
College
or
University
Technical
Vocational
LICENSE OR CERTIFICATES
CPA
ATTORNEY
PILOT
TEACHING
OTHER
General Experience
Legislative Experience
Typing ___________________ WPM
Accounting ________________ yrs.
Senate ______________________ yrs.
Legislative Budget Board _______ yrs.
Tested at _________________ WPM
Research __________________ yrs.
Computer _________________ yrs.
Clerical ___________________ yrs.
Governor ____________________ yrs.
Legislative Council ____________ yrs.
Type of System _______________
Shorthand _______________ WPM
Administration/
Lieutenant Governor ___________ yrs.
Constituent/Caseworker ________ yrs.
Printer/Publications __________ yrs.
Management ______________ yrs.
Receptionist/Secretary _______ yrs.
Legislative Aide _______________ yrs.
House of Representatives _______ yrs.
Proofreader ________________ yrs.
Foreign Languages
Speak
Read
Write
Fair
Good
Excellent
Fair
Good
Excellent
Fair
Good
Excellent
1. _____________________________________
Fair
Good
Excellent
Fair
Good
Excellent
Fair
Good
Excellent
2. _____________________________________
The Texas Senate is an Equal Opportunity Employer and does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in
employment or the provision of services.
OVER
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Parent category: Business