Apply At SWIS - Southwest Irrigation

Position Applying For *

Name *

First

Last

Email *

Phone Number *

Address

Social Security *

Date Available to Start *

Desired Salary *

Are you a citizen of the United States *

Have you ever worked for this company? *

Have you ever been convicted of a felony? *

EDUCATION

High School:

Address:

Dates Attended:

Example: From 2001 - 2005

Did you graduate?

Diploma:

College:

Address:

Dates Attended:

Example: From 2001 - 2005

Did you graduate?

Degree:

Other Education:

Address:

Dates Attended:

Example: From 2001 - 2005

Did you graduate?

Degree:

REFERENCES

Please list three professional references.

Reference #1 *

First

Last

Phone: *

Address:

Relationship:

Company:

Reference #2 *

First

Last

Phone: *

Address:

Relationship:

Company:

Reference #3 *

First

Last

Phone: *

Address:

Relationship:

Company:

PREVIOUS EMPLOYMENT

Company:

Phone

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Job Responsibilities

Date Started:

Date Left:

Reason For Leaving:

May we contact your previous employer?

Company:

Phone

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Job Responsibilities

Date Started:

Date Left:

Reason For Leaving:

May we contact your previous employer?

Company:

Phone

Address:

Supervisor:

Job Title:

Starting Salary:

Ending Salary:

Job Responsibilities:

Date Started:

Date Left:

Reason For Leaving:

May we contact your previous employer?

CERTIFICATIONS

Please list any professional licenses and certifications here.

MILITARY SERVICE

Are you currently in or have retired from the military?

SWIS celebrates diversity and are committed to creating an inclusive environment for all employees.

Newly hired employees are subject to a 30-day evaluation or introductory period to verify skills, capabilities and suitability for our company. The 30-day period also gives new employees the opportunity to evaluate SWIS as a place to work. All applicants are hired as "at will" employees (See page 5 in SWIS Employee handbook)

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Signature:

Date:

BACKGROUND CHECK FORM

All information will be kept strictly confidential.

Name *

First

Middle

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Maiden Name or Other Names Used:

Date of Birth

Drivers License #

DL Issue Date

Social Security #

If Address is less than 10 years, please list previous address.

Address Line 1

Address Line 2

City

State

Zip Code

Have you ever been arrested or convicted for any criminal offense excluding minor traffic violations?

Have you ever been accused, arrested or convicted of abuse or sexually related crimes?

Is there anything in your life-style or background that would call into question your ability?

Please explain if you answered yes to any of these questions:

If you answered yes to any of these questions, please explain: (Please note: answering" yes" to any of these questions does not automatically disqualify you). Please use the spaces provided to explain the circumstances. Thereby authorize Southwest Irrigation Systems, Inc. to make an independent investigation of my background and criminal or police records. I release Lone Star Screening Plus, LLC and any person or entity which provides information pursuant to this authorization, from all liabilities, claims or law suits in regard to the information obtained from any and all of the above sources. The information contained in this application is correct to the best of my knowledge. I understand that any omission of material fact on this application may be grounds for rejection of this application.

Signature:

Date:

CAREERSApply At SWIS

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EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

CERTIFICATIONS

MILITARY SERVICE

DISCLAIMER AND SIGNATURE

BACKGROUND CHECK FORM

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