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Texas Boll Weevil Eradication Foundation Inc. Employment Application P. O. Box 5089 Abilene TX 79608-5089 General Information 325- 672-2800 Fax 325-672-5034 What position s are you applying for Give title and announcement number if any. Name Last First Middle Social Security Number Mailing Address City State Zip Code Home Phone Were you ever employed by the TBWEF If yes job title Duties Location Dates of employment Please list any relatives that work or have worked for the Foundation* Work or Message Phone Are you eligible to work in the United States Upon hire you must show documents that establish identity and employment eligibility. Yes No All employment opportunities with TBWEF may require driving a foundation vehicle. Employment with the TBWEF requires a valid driver s license and fleet insurability according to Foundation guidelines. You will be required to provide your driver s license information to the Foundation* Our insurance carrier requires our drivers to be at least 18 years old. Are you over 18 years Yes How did you hear about employment with the TBWEF Availability When can you start work Month/Year What is the lowest pay you will accept In what district office s are you willing to work Are you willing to work 40 hours per week 1 to 4 months 25-32 hours per week Less than 1 month 17-24 hours per week 16 or fewer hours per week 1 to 5 nights each month On Call or Seasonal 6 to 10 nights each month Weekends 11 or more nights each month Overtime if required 5 to 12 months Print Name Date List each of your employers for the past 10 years starting with your last employer. Fill in as much information as you can* If you need more space use a plain sheet of paper. If resume is attached you must also complete the information below. Work Experience Employer/Company Phone Address of Company City State Zip Length of Employment Mth/Yr to Mth/Yr Your Position Title Supervisor Name Reason for Leaving Education School Name and Location Highest Grade/Degree Completed Completed Degree Qualifications/Abilities that you feel would help perform the job you are applying for Computer skills/training Agriculture experience I authorize the TBWEF to obtain information about me from my previous employers schools motor vehicle sources. I authorize my previous employers schools that I have attended motor vehicle department to disclose to TBWEF such information as the TBWEF may request. I also verify that the statements I have made in this application are true and complete. I understand that if I am hired any false or incomplete statement in this application will be grounds for immediate discharge. I acknowledge that if hired I will be an at will employee. I will be subject to dismissal or discipline without notice or cause at the discretion of the employer. I understand that the TBWEF is a drug free workplace and I may be subject to drug testing according to policy. Name Last First Middle Social Security Number Mailing Address City State Zip Code Home Phone Were you ever employed by the TBWEF If yes job title Duties Location Dates of employment Please list any relatives that work or have worked for the Foundation* Work or Message Phone Are you eligible to work in the United States Upon hire you must show documents that establish identity and employment eligibility. Yes No All employment opportunities with TBWEF may require driving a foundation vehicle. Employment with the TBWEF requires a valid driver s license and fleet insurability according to Foundation guidelines..

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