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Application for Employment

Frost is an Equal Opportunity Employer

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PERSONAL INFORMATION Incomplete information could disqualify you from further consideration

Name:

Address:

City:

State:

Zip Code:

Email:

Home Phone:

Cell Phone:

Time Zone:

Are you eligible to work in the U.S.?

Yes

Are you at least 18 years of age or older?

Yes

(If no, you may be required to provide authorization to work)

Have you ever signed a non-compete, non-solicitation agreement, or other type of restrictive covenant with any present or former employer?

Yes

If yes, please provide the employer name, type of business it is engaged in and further explain (you may be required to furnish a copy of the agreement in order to be considered for employment).

Employer:

Type of Business:

(further explain):

EMPLOYMENT DESIRED

Position Desired:

Date you can start:

Expected Salary:

Are you able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation?

Yes

Are you currently employed?

Yes

May we contact your present employer?

Yes

Have you ever pled "guilty" or "no contest" to or been convicted of a crime?

Yes

If yes, please provide date(s) and details:

ANSWERING "YES" TO THESE QUESTIONS DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT. SUCH FACTORS AS DATE OF THE OFFENSE, SERIOUSNESS AND NATURE OF THE VIOLATION, REHABILITATION AND POSITION APPLIED FOR WILL BE TAKEN INTO ACCOUNT.

Have you ever been terminated from employment or asked to resign by an employer?

Yes

If yes, please provide company name(s) and details:

Can you work any shift?

Yes

Can you work overtime, including weekends?

Yes

REFERRAL SOURCE

How did you hear about us?

Walk-In

Referral

Other

If referral or other, please provide more detail:

Have you ever worked for Frost before?

Yes

Do you know anyone who works for Frost?

Yes

If yes, who?

EDUCATION

High School: (name and location)

Years attended:

Degree earned:

Major/Subjects Studied:

College/University: (name and location)

Years attended:

Degree earned:

Major/subjects studied:

College/University: (name and location)

Years attended:

Degree earned:

Major/subjects studied:

Trade, Business or Correspondence School: (name and location)

Years attended:

Degree earned:

Major/subjects studied:

EMPLOYMENT HISTORY Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration

Number of Employers

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

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Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Date from-to:

Employer name:

Phone:

Job title:

Address:

Immediate supervisor & title:

Duties & responsibilities:

Hourly rate/Salary:

Reason for leaving:

Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for? (please describe)

Computer skills (please describe)

Upload resume (optional): .doc or .pdf format only

REFERENCES Please provide the names of three (3) references not related to you, whom you have known at least three (3) years.

Name:

Address, phone & email:

Company:

Years Acquainted:

Name:

Address, phone & email:

Company:

Years Acquainted:

Name:

Address, phone & email:

Company:

Years Acquainted:

APPLICANT STATUS (OPTIONAL)

We are subject to certain governmental record keeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, we invite our employees to voluntarily self-identify their race and ethnicity. Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information will be kept confidential and will only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. When reported, data will not identify a specific individual.

Do you wish to participate?

Yes - I understand the reason for this request for voluntary self-identification as stated above and have opted to participate

No - I understand the reason for this request for voluntary self-identification as stated above and choose to decline

APPLICATION STATEMENT

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.

I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contract and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute and agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the forgoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and the federal immigration laws require me to complete an I-9 Form in this regard.

I UNDERSTAND THAT ANY OFFER OF EMPLOYMENT IS CONTINGENT UPON SUCCESSFULLY PASSING A DRUG TEST AND THAT A PRE-EMPLOYMENT BACKGROUND SCREEN IS REQUIRED PRIOR TO THE START OF WORK.

By clicking Submit, below, I certify that I have read, fully understand and accept all the terms of the foregoing Application Statement: