Employment Application

Qualified applicants will receive equal consideration. No question is asked for the purpose of excluding any applicant on the basis of race, color, national origin, religion, age, sex, disability, or any other factor prohibited by law or regulation. Texas Cash and Pawn LLC (and its subsidiaries) is an equal opportunity employer.

PERSONAL INFORMATION

Date(Required)

Name(Required)

First Middle Initial Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Day Phone(Required)

Evening Phone(Required)

Email Address(Required)

Referred by

Position applying for(Required)

Date you can start(Required)

Salary desired

Are you currently employed?(Required)

Yes

May we inquire of your present employer?

Yes

Have you ever applied to this company before?(Required)

Yes

When?

Have you ever worked for this company before?(Required)

Yes

When?

AVAILABILITY FOR WORK

Type of work(Required)

Full-time

Part-time

Temporary

Shift desired(Required)

Day

Swing

Graveyard

Willing to Work Any

Will you work overtime during the work week if necessary?(Required)

Yes

Will you work weekend overtime if necessary?(Required)

Yes

Do you have any ongoing obligations or other personal commitments that would affect your work schedule?(Required)

Yes

Please describe

PERSONAL

Are you at least 18 years old?(Required)

Yes

If requested, would you be willing to take a drug/alcohol screening exam as a condition of employment?(Required)

Yes

Can you provide documented proof of U.S. citizenship or, if an alien, proof of authorization to work in the United States?(Required)

Yes

Have you ever been disciplined or terminated?(Required)

Yes

Please explain

Have you ever been convicted of any law violation, except a minor traffic violation? (A criminal record does not automatically bar employment)(Required)

Yes

Provide details

EDUCATION AND TRAINING

Name of High School(Required)

City & State(Required)

City State

Did you graduate?(Required)

Yes

Number of years attended

Major subjects, special courses, degrees

Name of College/University

City & State

City State

Did you graduate from College/University?

Yes

Number of years attended

Major subjects, special courses, degrees

Name of Graduate School

City & State

City State

Did you graduate from Graduate School?

Yes

Number of years attended

Major subjects, special courses, degrees

Other Education

City & State

City State

Did you graduate from Other Education?

Yes

Number of years attended

Major subjects, special courses, degrees

Licenses and Certifications

Other Skills

EMPLOYMENT RECORD: DO NOT indicate "see resume"

Give a complete account of your employment, including salary history. Begin on the first line with your present or most recent position and work back. Please attach an additional sheet if necessary and include all periods of unemployment.

Date Started

Date Ended

Employer Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Starting Salary

Ending Salary

Position/Duties

Reason for Leaving

Supervisor's Name & Title

What did you like about this job?

What did you dislike about this job?

Date Started

Date Ended

Employer Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Starting Salary

Ending Salary

Position/Duties

Reason for Leaving

Supervisor's Name & Title

What did you like about this job?

What did you dislike about this job?

Date Started

Date Ended

Employer Name

Address

Street Address Address Line 2 City State ZIP Code

Phone

Starting Salary

Ending Salary

Position/Duties

Reason for Leaving

Supervisor's Name & Title

What did you like about this job?

What did you dislike about this job?

WORK REFERENCES: Please provide a minimum of three.

Name

First Last

Company & Title

Relationship to You

Phone

Name

First Last

Company & Title

Relationship to You

Phone

Name

First Last

Company & Title

Relationship to You

Phone

Name

First Last

Company & Title

Relationship to You

Phone

PERSONAL REFERENCES: Please provide a minimum of two people who are not related to you.

Name

First Last

Company & Title

Relationship to You

Phone

Name

First Last

Company & Title

Relationship to You

Phone

Name

First Last

Company & Title

Relationship to You

Phone

CERTIFICATE OF APPLICANT (Read carefully before signing.)

All information provided by me is true and correct to the best of my knowledge. I understand omissions or misrepresentations may result in rejection of my application or if employed, may result in subsequent dismissal. I hereby authorize all former employers, educational institutions, personal references and others identified hereon, including their employees or representatives, to furnish or provide full and complete records, documents or information to Texas Cash and Pawn LLC or its representative concerning my prior educational and work histories, criminal and driving records, or other information I have provided hereon. I waive, release, indemnify and hold harmless Texas Cash and Pawn LLC, its subsidiaries or affiliate companies, employees and representatives and all other persons or entities from all liability and all claims of any nature whatsoever pertaining to the disclosure or use of information or written material as described above. I understand that any employment agreement to the contrary must be in writing and approved by the Company's Chief Operating Officer or President. If employed, I agree to comply with all rules of the company as condition of continued employment.

Date(Required)

Signature(Required)

CAPTCHA

Weatherford: (817)-594-5111

Graham: (940)-282-2918

Bridgeport: (940)-394-3444

PERSONAL INFORMATION

AVAILABILITY FOR WORK

PERSONAL

EDUCATION AND TRAINING

EMPLOYMENT RECORD: DO NOT indicate "see resume"

WORK REFERENCES: Please provide a minimum of three.

PERSONAL REFERENCES: Please provide a minimum of two people who are not related to you.

CERTIFICATE OF APPLICANT (Read carefully before signing.)

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