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Applicant Information

First Name *

Middle Initial

Last Name (copy) *

Street Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

DOB *

Position Applying For *

Available Start Date *

Are you a citizen of the United States? *

If no, are you authorized to work in the U.S.?

Have you ever worked for this company? *

If so, when?

Are you related to any employee of this agency? *

If so, whom?

Type of Employment Sought *

Full-Time Only
Part-Time Only
Full or Part-Time

Hours Available *

Upload Your Resume *

Click or drag a file to this area to upload.

Upload Your Cover Letter

Click or drag a file to this area to upload.

Criminal History/Background

Have you ever been convicted of a felony? *

Please note that having a criminal history and/or convictions will not necessarily affect your application, however there are specific convictions that will disqualify you for employment with TPCS, Inc. due to the nature of the services we provide.

If yes, please explain the nature of the offense(s), date(s) of conviction(s), and time served for each offense:

Education

High School

High School Address

Address Line 1

Address Line 2

City

State

Zip Code

From

Did you graduate?

Degree

College

College Address

Address Line 1

Address Line 2

City

State

Zip Code

From

Did you graduate?

Degree

Other

Other Address

Address Line 1

Address Line 2

City

State

Zip Code

From

Did you graduate?

Degree

References

Please list three professional references.

Full Name *

Relationship *

Company *

Phone *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Reference 2

Full Name *

Relationship *

Company *

Phone *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Reference 3

Full Name *

Relationship *

Company *

Phone *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Military Service

Branch

From

Rank at Discharge

Type of Discharge

If other than honorable, please explain:

Previous Employment

Company

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor

Job Title

Starting Salary

Responsibilities

From

Reason for Leaving

May we contact your previous supervisor for a reference?

Previous Employment 2

Company

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor

Job Title

Starting Salary

Responsibilities

From

Reason for Leaving

May we contact your previous supervisor for a reference?

Previous Employment 3

Company

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Supervisor

Job Title

Starting Salary

Responsibilities

From

Reason for Leaving

May we contact your previous supervisor for a reference?

Additional Information

Please provide any pertinent information relevant to your skills and/or abilities for the position that you are applying for.

Additional Information

Disclaimer and Signature

I certify that the information/facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This agency is hereby authorized to make any investigations of my prior educational and employment history.

I understand that employment at this agency is “at will,” which means that either I or this agency can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor or manager, other than the Executive Director has any authority to alter the foregoing.

Signature *

Clear Signature

Date *

Applicant Information

Criminal History/Background

Education

High School

College

Other

References

Reference 2

Reference 3

Military Service

Previous Employment

Previous Employment 2

Previous Employment 3

Additional Information

Disclaimer and Signature