Port Fabricators
20000 S. Hwy. 48
Brownsville, Texas 78521
p. (956) 831-7557
f. (956) 831-7594

Personal

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

Social Security *

Email Address *

Have you ever been convicted of a felony in the last seven years? *

Yes

Explain Felony

Are you at least 18 years of age? *

Yes

Are you able to meet the attendance requirements of the position requested *

Yes

Job Interest/Skills

Position(s) applied for *

Salary Desired *

Have you worked with Port Fabricators before? *

Yes

If yes, when? Badge?

Type of employment requested *

Full Time

Part Time

Temporary

Summer

Date you could begin working * +

Are you eligible for employment in this country? *

Yes

Summarize any other special skills or qualifications *

Education

	Name and Location	Course of study	# of years	Degree, Diploma, Certificate
High School	Name and Location	Course of study	# of years	Degree, Diploma, Certificate
College or University	Name and Location	Course of study	# of years	Degree, Diploma, Certificate
Other Education	Name and Location	Course of study	# of years	Degree, Diploma, Certificate

Employment History (list most recent first)

Name of Employer *

Address

City

State

Zip Code

Supervisor and Title *

Your Title *

Employed from * +

To * +

Starting Salary *

Ending Salary *

Work Performed *

Reason for leaving *

Name of Employer

Address

City

State

Zip Code

Supervisor and Title

Your Title

Employed from +

To +

Starting Salary

Ending Salary

Work Performed

Reason for leaving

Name of Employer

Address

City

State

Zip Code

Supervisor and Title

Your Title

Employed from +

To +

Starting Salary

Ending Salary

Work Performed

Reason for leaving

References

	Name	Relationship	Phone Number
-	Name	Relationship	Phone Number
-	Name	Relationship	Phone Number
-	Name	Relationship	Phone Number

Acknowlegement

It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer"s service if I have been employed. Furthermore, I understand that just as I am free to resign at any time the employer reserves the right to terminate my employment at any time, with or without prior notice. I understand that no representative of the employer has the authority to make any assurances to the contrary. I give the employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the employer and its representatives from seeking such information and all other persons, corporations or organizations for furnishing such information.

Applicants Signature *

clear

Date * +