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CTL EMPLOYMENT APPLICATION

Date Of Application:
Applicant Information
Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age or marital status, the presence of a non-job-related medical condition or disability or any other legally protected status.

Position Applying For:

Email Address:

Referral Source:

First Name:

Last Name:

Address:

Phone Number:

Valid Texas Driver’s License number:

Do you have current motor vehicle liability insurance?:

Under what names have you been previously employed?:

If employed and you are under 18, can you furnish a work permit?:

Have you filed an application here before?:

Have you ever been employed here before?:

If yes, give date:

Are you employed now?:

If yes, may we contact your present employer?:

Are you prevented from lawfully becoming employed in this country because of Visa or immigration status?:

Are you on a lay-off and subject to recall?:

Can you travel if a job requires it?:

Have you been convicted of, been given probation or deferred adjudication in lieu of sentencing or plead no contest for any offence other than a minor traffic violation?:

If yes, please explain in detail:

Are you charged with an unresolved criminal offense? Are you charged with a crime that has not yet resulted in a plea of guilty, acquittal, deferred adjudication, conviction, probation, or dismissal?:

If yes, please explain in detail:

*Note: A “yes” answer to these questions does not automatically disqualify you for employment. The nature and date of the crime/charge and type of job for which you are applying will be considered. Falsification of this application is grounds for an automatic termination.

On what date would you be available for work?:

Are you available to work:


Employment History
Employer One
Employer Name:

Employer Phone Number:

Employer Address:

Dates Employed:

Job Title:

Supervisor:

Hourly Rate/Salary:

Reason for Leaving:

Summarize the nature of the work performed and job responsibilities:

Employer Two
Employer:

Employer Phone Number:

Employer Address:

Job Title:

Supervisor:

Hourly Rate/Salary:

Reason for Leaving:

Summarize the nature of the work performed and job responsibilities:


Education
High School Name:

Years Completed:

College/University Name:

Years Completed:

Diploma/ Degree:

Describe the Course of Study:

Describe Specialized Training, Apprentice-ship, Skills, and Extra Curricular Activities:

Honors Received:

State any additional information you feel may be helpful to us in considering your application:

Veteran of the U.S. Military Service?:

If yes, Which Branch?:


References
Reference Name:

Reference Phone:

Reference Email:

Reference Name:

Reference Phone:

Reference Email:

Reference Name:

Reference Phone:

Reference Email:

Upload your Resume:


Applicant’s Statement
Please read the Applicant’s Statement above and sign below ensuring you agree all statements are correct.
Applicant’s Signature:

About

Center for Transforming Lives works side-by-side with women and their children to disrupt the cycle of poverty throughout Tarrant County. Our services are two-generational and establish long-term financial and emotional well-being.