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This application will be sent to J. Brian Foster, President’s email only.

"*" indicates required fields

APPLICATION DATA

Programs, services and employment are equally available to everyone. Please inform the Human Resources Department if you require reasonable accommodation for the application for interview. *denotes required field

Name*

First Middle Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Phone

Cell / Other Phone

Email

Date Available to Start*

MM slash DD slash YYYY

Salary Requirement*

If you are under 18 and we required a work permit, can you provide one?*

Yes

No

I'm not under 18

If no, please explain:

Have you ever worked for this company?*

Yes

No

If yes, when?

Are you a citizen of the United States?*

Yes

No

If you are not a citizen, are you legally allowed to work in the US?

Yes

No

Type of employment desired?*

Full-time

Part-time

Temporary

Seasonal

Do you have a valid KS driver license?*

Yes

No

Have you ever plead "guilty", "no contest" or been convicted of a crime?*

Yes

No

If yes, please give dates and details.

Summarize your special skills or qualifications:

Who referred you to us?

EDUCATION

High School*

Address

Number of years completed?*

Did you graduate?*

Yes

No

GPA

Class Rank

Name of college / university?

Address

Number of years completed?

Did you graduate?

Yes

No

Degree

Major

GPA

Class Rank

Other Education

Other Education Address

Number of years completed?

Did you graduate?

Yes

No

Degree

Major

GPA

Class Rank

REFERENCES

Please furnish the names, addresses and telephone numbers of two people to whom you are not related and by whom you have not been employed.

Reference One

Name*

Phone*

Address

Reference Two

Name*

Phone*

Address

PREVIOUS EMPLOYMENT

Please begin with your most recent position.

Position One

Start Date (MM/DD-YYYY)*

End Date (MM/DD/YYYY)*

Position Held*

Firm Name*

Address*

Phone*

Supervisor*

Title*

Responsibilities*

Starting Salary*

Starting Title*

Ending Salary*

Ending Title

Reason for Leaving*

May we contact this employer for a reference?*

Yes

No

Position Two

Start Date (MM/DD-YYYY)

End Date (MM/DD/YYYY)

Position Held

Firm Name

Address

Phone

Supervisor

Title

Responsibilities

Starting Salary

Starting Title

Ending Salary

Ending Title

Reason for Leaving

May we contact this employer for a reference?

Yes

No

Position Three

Start Date (MM/DD-YYYY)

End Date (MM/DD/YYYY)

Position Held

Firm Name

Address

Phone

Supervisor

Title

Responsibilities

Starting Salary

Starting Title

Ending Salary

Ending Title

Reason for Leaving

May we contact this employer for a reference?

Yes

No

I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial or medical history and other related matters as may be necessary for an employment decision. I hereby release employers, schools or persons from all liability when responding to inquiries in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.*

I Agree

Today's Date

MM slash DD slash YYYY

Prefer a paper application?
Email to brian@tcs-ks.com or fax to 316.448.0404.

Download Employment Application

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405 N Cleveland | Wichita, KS 67214

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