Houston Controls, Inc.
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Online Application For Employment
Please Note: A Resume CANNOT substitute for completion of all parts of application
Application Date:
Position Applied For:
1. PERSONAL HISTORY
Full Name:

List any other names you have used if needed for verification of employment or education record:

Address:
City, State, Zip:
Home Phone:
Work Phone:
Mobile Phone:
Social Security Number:
   
2. EDUCATION
High School
Name of High School
or GED Issuer:
City and State:
Did you graduate:
What was the highest Year Completed?
College / University No. 1
School Name:
City and State:
Major Subject Studied:

Minor Subject Studied:
Number of Years Attended:
Degree Received:
College / University No. 2
School Name:
City and State:
Major Subject Studied:

Minor Subject Studied:
Number Years Attended:
Degree Received:
Other Training No. 1
Institution Name:
City and State:
Study or Specialization:
Dates Attended:
From to
Other Training No. 2
Institution Name:
City and State:
Study or Specialization:
Dates Attended:
 From to
   
3. EMPLOYMENT HISTORY
List last 10 years of employment history starting with your present or most recent position. Include all relevant paid, non-paid, volunteer, and military experience. List promotions as separate jobs. Resume CANNOT substitute for completion of this page.
May we contact your current employer?
Job No. 1  
Employer Name:
Address:
City, State, Zip:
Dates Employed:
From to
Starting Salary/Earnings:

$ per

Ending Salary/Earnings:
$ per
Exact Title of Your Position:
Name of Supervisor:
Phone Number:
Reason for Leaving:
Description of Work:
Job No. 2  
Employer Name:
Address:
City, State, Zip:
Dates Employed:
From to
Starting Salary/Earnings:

$ per

Ending Salary/Earnings:
$ per
Exact Title of Your Position:
Name of Supervisor:
Phone Number:
Reason for Leaving:
Description of Work:
Job No. 3  
Employer Name:
Address:
City, State, Zip:
Dates Employed:
From to
Starting Salary/Earnings:

$ per

Ending Salary/Earnings:
$ per
Exact Title of Your Position:
Name of Supervisor:
Phone Number:
Reason for Leaving:
Description of Work:
Job No. 4  
Employer Name:
Address:
City, State, Zip:
Dates Employed:
From to
Starting Salary/Earnings:

$ per

Ending Salary/Earnings:
$ per
Exact Title of Your Position:
Name of Supervisor:
Phone Number:
Reason for Leaving:
Description of Work:
   
4. MILITARY RECORD
Have you ever served on active duty in the armed forces of the United States?
Dates of Active Duty:
From: to
Type of Discharge:
Member of the Reserve:
Active or Inactive:
   
5. COURT RECORD

Have you ever been convicted of a crime?

If yes, list all such matters regardless of disposition.
Conviction will not necessarily disqualify an applicant from employment
Date:
Place and Department:
Charge:
Disposition:
Details:
Date:
Place and Department:
Charge:
Disposition:
Details:
Date:
Place and Department:
Charge:
Disposition:
Details:
   
6. Membership in Organizations
Are you or have you been a member in professional organizations related to the position applied for? If yes, list below:
Name:
City and State:
Former or Present:
If Present, list positions and extent of activity:
Name:
City and State:
Former or Present:
If Present, list positions and extent of activity:
Name:
City and State:
Former or Present:
If Present, list positions and extent of activity:
Name:
City and State:
Former or Present:
If Present, list positions and extent of activity:
   
7. RELATIVES
Do you have any friends and/or relatives employed by HCI?
If yes, list names, relationship, position and department.
Name:
Relationship:
Position:
Department:
Name:
Relationship:
Position:
Department:
Name:
Relationship:
Position:
Department:
   
8. PHYSICAL DATA
Having read the job description, are you able to perform all essential elements of the position?
If no, explain:
 
9. SKILLS (Complete only if related to the position applied for)
Do you have a valid driver's license?
State of Issue:
What class of license do you have?
A, B, or C:
(C is formerly a Class D)
Commercial/Non-Commercial:
License Number:
 
List any special qualifications, skills or licenses you hold relevant to the position for which you are applying which are not covered elsewhere in this application, to included office equipment, construction equipment and language skills.
 
10. OTHER REFERENCES
Include other references not listed in employment history:
Complete Name:
(Last, First, Middle)
Address:
City, State, Zip:
Home or Business:
Phone Number:
Business or Occupation:
Years known:
Complete Name:
(Last, First, Middle)
Address:
City, State, Zip:
Home or Business:
Phone Number:
Business or Occupation:
Years known:
Complete Name:
(Last, First, Middle)
Address:
City, State, Zip:
Home or Business:
Phone Number:
Business or Occupation:
Years known:
   
11. PRIOR EMPLOYMENT WITH HOUSTON CONTROLS
Have you ever applied for employment with HCI?
If yes, what position(s):
When:
Have you ever been employed by HCI?
If yes, what position(s):
Dates of prior employment:
from to
Reason for Leaving:
   
13. PERSONAL DECLARATIONS

Within the last five years, have you been fired for any reason?

If yes, give details:
Within the last five years, have you quit a job after being notified that you would be fired?
If yes, give details:
   
A.
 UNDER THE IMMIGRATION CONTROL ACT OF 1986, AN EMPLOYER IS REQUIRED TO HIRE ONLY U.S. CITIZENS AND LAWFULLY AUTHORIED ALIEN WORKERS. APPLICANTS WHO ARE SELECTED FOR EMPLOYMENT WILL BE REQUIRED TO SHOW AND VERIFY AUTHORIZATION TO WORK IN THE UNITED STATES, WITHIN THREE (3) DAYS OF BEGINNING WORK.
   
B.
 I understand that I may be required to submit to such related examinations as may be required. I also understand that I must submit to a physical examination in which includes a drug screening.
   
C.
 Acceptance of this application is not intended to create or imply a contractual relationship. If hired, I understand I will be required to serve a probationary period during which time my job performance and conduct will be evaluated, and that my employment may be terminated if either performance or conduct is unsatisfactory. I also understand that all benefits of employment are subject to change by HCI management with or without notice.
   
D.
 I authorize investigation of all statements contained in this application for employment. I understand that any false or incomplete answer may be grounds for not employing me or for dismissing me after I begin work.
   
E.
 I certify that every answer and statement that I have made in this application is true and complete to the best of my knowledge.
   
Note: you must fill-in both areas below or the form will not submit
Enter Your Full Name Here: *Required
Enter Your Email Address Here: *Required
 
HCI considers applicants for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, non-disqualifying physical or mental handicap, personal appearance, political opinion, sexual orientation, labor organization affiliation, or any other legally protected status.

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