Variosystems Inc.
Employment Application
901 S Kimball Ave., Southlake, TX 76092

POLICY & INSTRUCTIONS
As an Equal Opportunity Employer, Variosystems Inc. does not discriminate on the basis of race, color, religion, sex, national origin, age, disability or sexual orientation. No question on this application is intended to secure information to be used in a discriminatory manner. A routine inquiry into relevant background information may be conducted as a part of the applicant screening process. As part of this process, you may be asked to undergo a physical examination, including a drug test. In addition, satisfactory criminal background records, employment references and educational references may be required for employment. Some positions may require a credit check.
APPLICANT & JOB INFORMATION
Enter your name as it appears on Social Security Card:
First
Middle
Last
Street Address
City
State
Zip Code
Country
Primary Telephone Number
Secondary Telephone Number
E-mail address
Position Applying for
Type of Work Seeking? Full Time Part Time Temporary Days Nights
Desired Salary
Date Available to begin employment
EDUCATION
Name of High School
City and State or Country
Did you graduate? Yes No GED
Name of College / University
City and State or Country
Degree
Major / Discipline
Overall GPA
Begin Date
End Date
Years Completed
Did you graduate? Yes No
If you attended school under a different name, please state name:
Name of College / University
City and State or Country
Degree
Major / Discipline
Overall GPA
Begin Date
End Date
Years Completed
Did you graduate? Yes No
If you attended school under a different name, please state name:
 
ADDITIONAL SKILLS, TRAINING, CERTIFICATIONS, LICENSES & PROFESSIONAL MEMBERSHIPS
You may exclude any organization or activity, the name of which indicates your race, sex, color, religion, national origin, age, disability or sexual orientation.
PRIOR WORK EXPERIENCE (INCLUDING MILITARY EXPERIENCE)
Begin with most recent employer. Do not write "See Resume".
Company Name
Job Title
Street Address
City and State, Zip Code
Job Description
Salary
Begin Date
End Date
Reason for Leaving
If you worked under a different name, please state name:
May we contact this employer as a reference prior to making a hiring decision? Yes No
Company Name
Job Title
Job Description
Salary
Begin Date
End Date
Reason for Leaving
If you worked under a different name, please state name:
Company Name
Job Title
Job Description
Salary
Begin Date
End Date
Reason for Leaving
If you worked under a different name, please state name:
COMPUTER SKILLS
Please Check Current Computer Skills:
SAP Microsoft Excel Database Management
Netscape (& Explorer) Microsoft Access Microsoft Power Point
E-Mail Program (Outlook) Microsoft Word  
 
GENERAL INFORMATION
Are you 18 or over? Yes No
Are you legally eligible to work in the U.S. on a continuous basis other than for practical training purposes?
Yes No
Have you ever been convicted of a crime other than a minor traffic violation? (Include DUI's) NOTE: Convictions are not an absolute bar to employment. Consideration is given to factors including the nature and age of offense.
Yes No If yes, please explain fully below.
Offense
Date
Location
Disposition
Offense
Date
Location
Disposition
Do you have a relative working in Variosytems Inc.? Yes No
Name
Relationship
Department
Have you been previously employed by Variosystems Inc.? Yes No If yes, please complete:
Location
Starting date
Ending date
Reason for Leaving
If hired, will you be involved in any other employment or income-producing venture? Yes No
If yes, please complete:
Name of business
Nature of business
Amount of time it requires
 
HOW DID YOU LEARN ABOUT THIS JOB OPPORTUNITY?
Advertising (includes newspaper, trade magazine, internet job site, etc.)
Source Name:
Referral (includes professional association, friend, government employment office, business associate)
Source Name:
Other (includes job fair, job posting, college recruiting)
Please Explain:
 
APPLICANT'S STATEMENT
*If this application is completed digitally, this statement is agreed to once the applicant has
emailed the completed to: jobs@variosystems.com
I, certify that the facts set forth in this employment application, resume, or any other information provided are true and complete to the best of my knowledge. I understand that falsified statements or omitted information in this application may result in my no longer being considered for employment or, if employed, may result in my dismissal. I authorize any investigation of the information provided by me in this employment application, resume, or any other information product provided as may be necessary to arrive at an employment decision. Furthermore, I release Variosystems Inc. from any liability resulting from any investigation and release all parties and persons connected with any request for information from all claims, liability and damages which might arise from release or use of this information.
I authorize Variosystems Inc. to conduct an investigation of my criminal background and any necessary tests to determine the illegal use of drugs or controlled substances. I consent for the release of such test results and other relevant medical information to authorized personnel. I understand that my refusal to consent or testing positive or any negative information received from my criminal background check is grounds for refusal to hire, or, if hired, grounds for termination of employment by the Company.
I understand that appointment to a position with Variosystems Inc. is without obligation as to the term of employment and that my employment may be terminated with or without cause at the Company's option and without liability for salary, except that which has been earned as of the date of my termination.
I hereby acknowledge that I have read, understand and agree to the above statements.
Applicant's Signature Date 09/17/19