Aprotex

Online Application


Our Company is an equal opportunity employer and will consider all applicants for all positions without regard to their race, sex, age, color, religion, national origin, veteran status or any disability as provided in the Americans With Disabilities Act.

This application will be given every consideration, however, its receipt does not imply that the applicant will be employed. Each question should be answered in a complete and accurate manner, as no action can be taken on this application until all questions have been answered.


Name: (Last, First, Middle)
 Home Phone: (Include Area Code)
 
Address:
City:
State:
Zip Code:
Email:
Are you over the age of 18?
Yes
No
 		Do you have Legal Right to be employed in the United States?
Yes
No
Have you ever been convicted or received deferred judification for any crime (Excluding any minor traffic violations) but including offenses for driving while under the influence of alcohol or drugs?
Yes
No
 
If Yes to the previous Question, state the offense, date, and disposition:
 
Are you willing to work overtime or to travel if they are a part of the job for which you are applying?
Yes
No

Drivers License Information:
State:
Type:
Number:
Is your Drivers License currently Valid?
Yes
No
Are you seeking
Full Time
Part Time
Position Applying for:
 Desired Salary:
Date Available to start:
Have you worked for our company before?
Yes
No
 
If Yes to the previous Question, When and where?
 
How did you learn of our company and / or position?
 
Are you, or do you expect to be working in any other business or jobs other than our company?
Yes
No
Education
High School
(Name, Street, and Location)
 Graduated?
Yes
No
GED
 Diploma:
College
(Name, Street, and Location)
 Graduated?
Yes
No
 Degree:
Trade School
(Name, Street, and Location)
 Graduated?
Yes
No
 Degree:

Are you Planning any Future Studies?
Yes
No
 If so, When and where?
 
Describe any specialized training, which might help you in the position for which you are applying:

Military

Have you ever served in the military?
Yes
No
If so, Which Branch:
 Date Joined:
Type of Discharge:
 Date Separated:
Capability / Reliability
Will you abide by the safety rules of this company?
Yes
No
 Have you ever been disciplined for violating company safety rules or regulations?
Yes
No


If yes to the question above, please explain:
 
How many days of work have you missed in the last 2 years?
 How many days have you been late to work in the last two years?
 
Have you ever been disciplined or received verbal or written warning for absenteeism or tardiness?
Yes
No
 
Are you employed at this time?
Yes
No
 May we contact your present employer?
Yes
No
N/A
Work History

List the names of employers in consecutive order with present or last employer first. Account for all periods of time including militart service, periods of unemployment, or self-employment.
Job 1:

Employer: Supervisor:
Address: Employed from:
To:
City, State: Starting Salary:
Telephone: Ending Salary:
Job Title: Type of Business:
Duties: Reason for Leaving:
Job 2:

Employer: Supervisor:
Address: Employed from:
To:
City, State: Starting Salary:
Telephone: Ending Salary:
Job Title: Type of Business:
Duties: Reason for Leaving:
Job 3:

Employer: Supervisor:
Address: Employed from:
To:
City, State: Starting Salary:
Telephone: Ending Salary:
Job Title: Type of Business:
Duties: Reason for Leaving:
Supplemental Emplyment Information

If you worked in any of your previous positions under another name, please give that name or names below:


References

Give three references, do not list relatives or former employers.
Reference #1:

Name: Address:
City: Phone Number:
State: Occupation:
Reference #2:

Name: Address:
City: Phone Number:
State: Occupation:
Reference #3:

Name: Address:
City: Phone Number:
State: Occupation:

I certify that my answers to the foregoing questions are true and correct without any consequential omissions of any kind whatsoever. I understand that if I am employed, and false, misleading or otherwise incorrect statements made on this application form or during any interviews may be grounds for my immediate discharge.

I hereby authorize Aprotex to contact any company or individual it deems appropriate to investigate my employment history, character, and qualifications and I give my full and complete consent to their revealing any and all information they wish as a result of this investigation. In addition, I hereby waive my right to bring any cause of action against these individuals for defamation, invasion of privacy or any other reason because of their statements.

I understand that my employment is "AT WILL" and may be terminated by myself or by the company at any time for any reason or for no reason at all, with or without prior notice.



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Aprotex Corporation, 1011 W Washington Ave.,
Midland, Tx, 79701-6667, (432)570-0188

All Trademarks used by permission. Aprotex and the Aprotex Logo are copyrighted © 2010 Aprotex Corporation. All Rights Reserved.

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