The State Of Texas Application For Employment (Page 2 of 5) in pdf

AN EQUAL OPPORTUNITY EMPLOYER

If a license, certificate, or other authorization is required or related to the position for which you are applying, complete the following:

LICENSE/CERTIFICATION

Date

Issued by/Location of issuing authority

(P.E., R.N., Attorney, C.P.A., etc.)

issued

expires

(State or other authority) (City & State)

License No.

Special Training/Skills/Qualifications: List all job related training or skills you possess and machines or office equipment you can use, such as

calculators, printing or graphics equipment, computer equipment, types of software and hardware. (Attach additional page, if necessary.)

Approximately how many words per minute do you type?

Sign Language (If required for this position) Yes

Are you a certified interpreter? Yes

Do you speak a language other than English? (If required for this position) Yes

If yes, what language(s) do you speak?

How fluently? Fair

Good

Excellent

Do you write in a language other than English? (If required for this position) Yes

If yes, which language(s)

Have you ever been employed by the State of Texas? Yes

Are you currently employed by the State of Texas? Yes

If you have been previously employed by the State of Texas, list the agency/agencies:

FORMER FOSTER YOUTH (Verification may be required.)

Were you a foster youth under the Texas Department of Family and Protective Services on the day before your 18

birthday? Yes

If yes, are you currently 25 years of age or younger? Yes

MILITARY SERVICE (A copy of a report of separation from the Armed Services may be required.)

Are you a veteran? Yes

If yes, list type of discharge

status _____________________

Dates of Service (From/To):

Are you a surviving spouse of a veteran who has not remarried? Yes

Are you a surviving orphan of a veteran? Yes

If yes, complete dates of service for veteran

(From/To):

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY AND INDICATE YOUR

UNDERSTANDING AND ACCEPTANCE BY SIGNING IN THE SPACE PROVIDED

I certify that all the information provided by me in connection with my application, whether on this document or not, is true and

complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to hire or, if

hired, termination.

I understand that as a condition of employment, I will be required to provide legal proof of authorization to work in the U.S.

I understand that the State of Texas requires all males who are 18 through 25 and required to register with the Selective Service, to

present either proof of registration or exemption from registration upon hire.

I understand that some state agencies will check with the Texas Department of Public Safety, the Federal Bureau of Investigation or

other organizations, for any criminal history in accordance with applicable statutes.

I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my

previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects

covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such

information to you.

THIS APPLICATION MUST BE SIGNED

SIGN HERE:

Signature – Applicant

Date

(0909)

Page 2 of 4

The State Of Texas Application For Employment Page 2

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