This form contains 127 fields organized into 23 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Additional education (Row 4)
Row 4 - Field of study Text
Enter the primary field, major, or area of study you pursued at this institution (e.g., Accounting, Mechanical Technology).
Row 4 - Years completed Text
Enter the number of years you completed at this institution using digits (e.g., 1, 2, 3).
Row 4 - Institution name Text
Enter the name of the additional educational institution or school for this fourth row (e.g., name of high school, college, or training provider).
Row 4 - Graduate or degree Text
Enter the degree, certificate, or graduation status earned at this institution (e.g., 'Bachelor', 'Certificate', or 'No degree').
Business/technical education (Row 3)
Business/technical (Row 3) - Years completed Text
Enter the number of years of education or training you completed at the business/technical institution listed in this row.
Business/technical (Row 3) - Institution name Text
Enter the full name of the business or technical school, college, or training institution you attended for this Business/technical entry.
Business/technical (Row 3) - Field of study Text
Provide the primary field, major, or subject area you studied at the business/technical institution (for example: Accounting, Electronics, Welding).
Business/technical (Row 3) - Graduate or degree Text
Enter the degree, diploma, certificate, or other credential you earned at this business/technical institution, or indicate if none was awarded.
College/university education (Row 2)
Row 2 - Years completed Text
Enter the number of years you completed at this institution (for example: 1, 2, 3, 4).
Row 2 - Institution name Text
Enter the name of the college or university you attended for this row (e.g., institution or campus name).
Row 2 - Field of study Text
Enter the major, concentration, or primary field of study you pursued at this institution.
Row 2 - Graduate or degree Text
Enter the degree, diploma, certificate earned or the highest level completed at this institution (e.g., B.A., B.S., none).
CONTACT
Contact Relationship Text
The relationship of the contact to you (for example: spouse, parent, friend, coworker).
Contact Daytime Phone Text
A daytime phone number where the contact can be reached; include area code and country code if applicable.
Contact Name Text
The full name of the person to be contacted in case of illness or accident.
Contact Address Text
The contact's full mailing address, including street, city, state/province and ZIP/postal code.
Driver's License and Endorsements
Issuing State (Driver's License) Text
Enter the U.S. state or jurisdiction that issued your driver's license (commonly the two-letter state abbreviation). Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Driver's License Number Text
Enter your full driver's license number exactly as it appears on the license, including any letters or leading zeros. Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Issuing state Checkbox
Check this box if you will provide the issuing state for your driver's license (then enter the state in the Issuing state field). Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Provide a valid Texas Driver's License — No Checkbox
Check this box if you cannot provide a valid Texas driver's license.
Work overtime — No Checkbox
Check this box if you are not able or willing to work overtime when required for the job.
Work overtime — Yes Checkbox
Check this box if you are able and willing to work overtime when required for the job.
Tank with Hazardous Materials Checkbox
Check this box if your driver's license includes the Tank with Hazardous Materials endorsement. Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Double/Triple trailers Checkbox
Check this box if your driver's license includes the Double/Triple trailers endorsement. Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Passengers Checkbox
Check this box if your driver's license includes the Passenger endorsement. Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Provide a valid Texas Driver's License — Yes Checkbox
Check this box if you can provide a valid Texas driver's license.
School Bus Checkbox
Check this box if your driver's license includes the School Bus endorsement. Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Tankers Checkbox
Check this box if your driver's license includes the Tanker endorsement. Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Hazardous Material Checkbox
Check this box if your driver's license includes the Hazardous Material (H) endorsement. Fill only if 'Provide a valid Texas Driver's License — Yes' Fill only if Provide a valid Texas Driver's License? is 'Yes'.
Depends on: Provide a valid Texas Driver's License — Yes
Employment History Header
Employment History 1 Section Number Text
Enter the identifier or number for this employment history section (e.g., 1) to indicate this is the first employment entry.
Employment History Row 1
Row 1 - Position title / duties Text
Enter your job title and a brief summary of duties, responsibilities, and key skills used in this position.
Row 1 - End date Date
Enter the date your employment with this employer ended.
Row 1 - Reason for leaving Text
Briefly state the reason you left this position (for example: resignation, termination, layoff, career change).
Row 1 - Start date Date
Enter the date you began employment with this employer.
Row 1 - Employer city/state/ZIP Text
Enter the city, state and ZIP code for the employer's address.
Row 1 - Employer address / line 2 Text
Enter the second line of the employer address such as street address or suite number.
Row 1 - Pay period Text
Enter the pay period or basis for the pay amount (for example 'hour', 'week', 'month', or 'year').
Row 1 - Pay amount Number
Enter the pay amount you received for this position.
Row 1 - Supervisor telephone Text
Enter the supervisor's telephone number for reference or verification.
Row 1 - Supervisor name Text
Enter the full name of your supervisor at this employer.
Row 1 - Employer name / line 1 Text
Enter the employer's name or the first line of the employer address (usually company name).
Employment History Row 2
Row 2 Position title / Duties / Skills Text
Enter your job title and a brief description of duties, responsibilities, and skills performed in this position.
Row 2 Reason for leaving Text
Briefly state the reason you left or are leaving this position.
Row 2 Employer name/address line 2 Text
Enter the second line of the employer name or address (suite, building, or additional address details).
Row 2 Employment end date Date
Provide the date your employment with this employer ended or indicate if you are still employed.
Row 2 Employment start date Date
Provide the date you began employment with this employer.
Row 2 Employer city/state/zip Text
Enter the city, state and ZIP code (or other locality information) for the employer's address.
Row 2 Pay frequency (Per) Text
Enter the pay period or frequency for the amount provided (for example: hour, week, month, year).
Row 2 Pay amount Number
Enter the pay rate or salary amount you received for this position.
Row 2 Supervisor name Text
Enter the full name of your supervisor or manager at this employer.
Row 2 Supervisor telephone Text
Enter the telephone number for your supervisor, including area code as applicable.
Row 2 Employer name/address line 1 Text
Enter the employer name or the first line of the employer's street address for this job.
Employment History Row 3
Row 3 Position Title / Duties / Skills Text
Describe the job title, main duties and relevant skills you performed in this position.
Row 3 Reason for Leaving Text
Provide the primary reason you left this position (for example: relocation, termination, better opportunity).
Row 3 Employer - Name/Address Line 2 Text
Enter the second line of the employer name or address (suite, city, etc.) for the third employment entry.
Row 3 End Date Date
Enter the date you ended this employment or leave blank if still employed.
Row 3 Employer - Name/Address Line 3 Text
Enter the third line of the employer name or address (state, ZIP or additional details) for the third employment entry.
Row 3 Start Date Date
Enter the date you began this employment.
Row 3 Pay Number
Enter the pay amount you received for this job.
Row 3 Pay - Period Text
Specify the pay period for the amount entered (for example: hour, week, month, or year).
Row 3 Supervisor Text
Enter the name of your supervisor at this employer.
Row 3 Supervisor Telephone Text
Enter the telephone number where your supervisor can be reached regarding this job.
Row 3 Employer - Name/Address Line 1 Text
Enter the first line of the employer name or street address for the third employment entry.
Employment History Row 4
Row 4 Position title / Duties Text
Enter the job title and a brief summary of the duties and skills performed in this position.
Row 4 Reason for leaving Text
Briefly explain the reason you left (or would leave) this employment.
Row 4 Start date Date
Enter the date you began working in this position.
Row 4 End date Date
Enter the date this employment ended or indicate if you are still employed.
Row 4 Employer name & address - Line 2 Text
Enter the second line of the employer address (suite, city, or additional address details).
Row 4 Employer name & address - Line 3 Text
Enter the third line of the employer address (state, ZIP code, or other location information).
Row 4 Pay amount Number
Enter the pay amount you received for this job.
Row 4 Employer name & address - Line 1 Text
Enter the employer name or the first line of the employer's address (company name or street).
Row 4 Pay period Text
Specify the pay frequency or rate period for the pay entered (for example hourly, weekly, or monthly).
Row 4 Supervisor telephone Text
Provide the telephone number for your supervisor at this job.
Row 4 Supervisor name Text
Provide the full name of your supervisor at this employer.
First Reference
First Reference — Name Text
Enter the full name of your first personal reference (given name and surname).
First Reference — Address Text
Enter the mailing address for this reference, including street, city, state/province and postal code.
First Reference — Telephone Text
Enter the primary telephone number for this reference, including area code and any extension if applicable.
First Reference — Years Known Text
Enter the number of years (or approximate years) you have known this reference.
First Reference — Occupation Text
Enter the current job title or occupation of this reference.
Functional Ability & Employment Eligibility
Days until available to report Text
Enter the number of days after notification that you will be able to report to work (e.g., 0 for immediately, 7 for one week).
Availability details / earliest start date Text
Provide any additional availability information or notes about your earliest start date or special conditions related to when you can begin work.
Legally eligible for employment in the U.S. — Yes Checkbox
Check this box if you are legally authorized to work in the United States.
Provide a valid Texas Driver's License — Yes Checkbox
Check this box if you can provide a valid Texas driver's license when required for the position.
Seeking a permanent position — No Checkbox
Check this box if you are not seeking a permanent position (e.g., seeking temporary or seasonal work).
Able to perform essential functions with or without accommodations — Yes Checkbox
Check this box if you can perform the essential functions of the job with or without reasonable accommodations.
Seeking a permanent position — Yes Checkbox
Check this box if you are seeking a permanent position with the employer.
Legally eligible for employment in the U.S. — No Checkbox
Check this box if you are not legally authorized to work in the United States.
Able to perform essential functions with or without accommodations — No Checkbox
Check this box if you are unable to perform the essential functions of the job even with accommodations.
General
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High school education (Row 1)
High school (Row 1) - Years completed Text
Enter the number of years of high school you completed for this entry (for example, '3' or '4').
High school (Row 1) - Field of study Text
Enter the primary field, focus, or major you studied in high school for this entry (for example, 'General Studies', 'Science', or 'Business').
High school (Row 1) - Institution name Text
Enter the full name of the high school you attended for this entry (for example, 'Lincoln High School').
High school (Row 1) - Graduate or degree Text
Enter the diploma or credential earned or indicate graduation status for this entry (for example, 'High School Diploma', 'GED', or 'Did not graduate').
INFORMATION TO THE APPLICANT
Applicant Initials Text
Enter your initials to acknowledge that you have read and agree to the information in this section.
Applicant Printed Name Text
Type your full printed name exactly as you want it to appear on the application.
Date Signed Date
Enter the date on which you signed the application.
Signature of Applicant Text
Provide your handwritten or electronic signature to certify that the information provided is true and complete.
MILITARY
Are you a veteran? - No Checkbox
Check this box if you are not a military veteran.
Are you a veteran? - Yes Checkbox
Check this box if you are a military veteran.
Duty / Specialized Training Text
Enter your military duties and any specialized training, courses, units, qualifications, or certifications you completed (include brief details such as dates or rank where relevant). Fill only if 'Are you a veteran? - Yes' is 'Yes'.
Depends on: Are you a veteran? - Yes
Page 2
Other Employment Summary Text
Briefly summarize any other employment related to this job, including relevant positions, employers, dates, and key duties.
Additional Information / Comments Text
Enter any additional information, comments, or clarifications you want to provide on this page that are not captured elsewhere on the form.
Further Details or Qualifications Text
Provide any further details, qualifications, licenses, or explanations relevant to your application that should appear prior to the Education section.
Personal and Contact Information
Primary Telephone Text
Enter your primary telephone number including area code so we can contact you (e.g., (555) 555-5555).
Alternate Telephone Text
Enter an alternate telephone number where you can be reached if the primary number is unavailable.
Email Address Text
Enter your preferred email address for correspondence and contact.
Mailing Address Text
Enter your full mailing address, including street address, city, state, and ZIP code.
Name (Last, First) Text
Enter your full name with last name first followed by your first name (include any suffixes if applicable).
Middle Name or Initial Text
Enter your middle name or middle initial.
Position Applying For
Position Applying For Text
Enter the job title or position you are applying for (e.g., 'Laboratory Technician', 'Field Analyst' or specific vacancy code) as it appears on the posting.
Second Reference
Second Reference - Telephone Text
Daytime telephone number where the second reference can be reached, including area code and extension if applicable.
Second Reference - Occupation Text
Current job title or occupation of the second reference.
Second Reference - Years Known Text
How long you have known the second reference, expressed in years (or years and months).
Second Reference - Address Text
Complete mailing address for the second reference, including street, city, state/province and ZIP/postal code.
Second Reference - Name Text
Full name of the second personal reference (do not list a relative or a former supervisor).
Skills & Qualifications - Descriptions
Types of computers, software and equipment Text
List the computers, software, tools, machinery, or other equipment you are qualified to operate or repair, including any relevant versions or proficiency notes.
Professional licenses, certifications or registrations Text
Provide any professional licenses, certifications, or registrations you hold, including the issuing organization and any identifying numbers or dates if applicable.
Additional skills, languages or supervision experience Text
Describe other relevant skills such as supervisory experience, foreign languages spoken, or other career/occupation information you wish to bring to the employer’s attention.
Other qualifications (skills/honors) Text
Enter any additional qualifications, special skills, abilities, honors, or awards that should be considered for this application.
Third Reference
Third Reference — Address Text
Enter the complete mailing address for the third reference, including street, city, state/province and ZIP or postal code.
Third Reference — Occupation Text
Enter the current occupation or job title of the third reference.
Third Reference — Telephone Text
Enter the best telephone number to reach the third reference, including area code and any extension if applicable.
Third Reference — Name Text
Enter the full name (first and last) of the third personal reference.
Third Reference — Years Known Text
Enter how many years you have known the third reference (provide a numeric value such as '3' or '5').
Typing Speed (words per minute and details)
Typing speed (wpm) Text
Enter your typing speed as the number of words per minute you can type.
Typing speed details Text
Provide any additional information about your typing ability such as accuracy, how the speed was measured (e.g., tested or estimated), shorthand skills, or other relevant comments.