Employment Applications

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Type	Class	Manufacturer	Configuration
Check	#900	Firsa	Pressure Seal Design
Check	#900	TY Valve Corp.	Bolted Cover
Check	#900	TY Valve Corp.	Pressure Seal Design
Check	#900 #1500 #2500	Neway	Bolted Cover
Check	#900 #1500 #2500	Neway	Pressure Seal Design
Check	#900	Kinka	Bolted Cover
Check	#900	Kinka	Pressure Seal Design
Check	#1500	Firsa	Bolted Cover
Check	#1500	Firsa	Pressure Seal Design
Check	#1500	Beric Valves	Y-Pattern Bolted Cover Std Port

Date: *

Name: *

Address: *

State/Province: *

Zip/Postal Code: *

Home Phone: *

Cell Phone: *

Email: *

Position(s) Desired: *

Salary Desired: *

10203 Wallisville Rd.
Houston, TX USA 77013
Phone: 713.675.8186
Fax: 713.670.3974
www.LockwoodInt.com

Equal Opportunity Employer

Hours Available to Work

Mon:

Tues:

Wed:

Thurs:

Fri:

Sat:

Sun:

Full Time

Part Time

Full or Part-Time

Date available to begin work?:

Are you currently employed?: *

yes

If so, may we contact your present employer?: *

yes

Education

High School

Name of School:

Complete Mailing Address:

No. Years Completed:

Major or Degree:

Undergraduate

Name of School:

Complete Mailing Address:

No. Years Completed:

Major or Degree:

Graduate

Name of School:

Complete Mailing Address:

No. Years Completed:

Major or Degree:

Trade, Technical or Business School

Name of School:

Complete Mailing Address:

No. Years Completed:

Major or Degree:

Other

Name of School:

Complete Mailing Address:

No. Years Completed:

Major or Degree:

Have you ever been convicted of a felony?: *

yes

If yes, please explain:

Do you have a valid drivers license?: *

yes

If yes: State of issue:

Drivers License #:

Do you have a valid commercial drivers license?: *

yes

If yes, what class?:

Have you had any accidents in the past 3 years?: *

yes

If yes, how many?:

Do you had any moving violations in the past 3 years?: *

yes

If yes, how many?:

Are you legally eligible for employment in the United States?: *

yes

Previous Employment (list up to 3)

Employer 1

Name of Employer:

Name of Supervisor:

Dates of employment

From:

To:

Salary

Begin:

End:

Complete Address:

Phone #:

Last job title:

Reason for Leaving (be specific):

List the job duties you performed, skills used or learned, advancements, or promotions while you worked at this company:

May we contact this employer:

yes

Employer 2

Name of Employer:

Name of Supervisor:

Dates of employment

From:

To:

Salary

Begin:

End:

Complete Address:

Phone #:

Last job title:

Reason for Leaving (be specific):

List the job duties you performed, skills used or learned, advancements, or promotions while you worked at this company:

May we contact this employer:

yes

Employer 3

Name of Employer:

Name of Supervisor:

Dates of employment

From:

To:

Salary

Begin:

End:

Complete Address:

Phone #:

Last job title:

Reason for Leaving (be specific):

List the job duties you performed, skills used or learned, advancements, or promotions while you worked at this company:

May we contact this employer:

yes

Skills:

Keyboarding WPM:

Computer: *

Mac

Both

Applications (list all that apply):

Other Skills:

Please list 2 references other than relatives and previous employers

Reference

Name:

Position:

Company:

Telephone:

Reference

Name:

Position:

Company:

Telephone:

Additional information necessary to describe your full qualifications for the position which you are applying:

By submitting this document I agree to the following:

Authorization

“I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that falsified statements on this application shall be grounds for being refused employment or, if employed, grounds for dismissal. I acknowledge that by submitting this completed application it does not indicate that any positions are open nor does it obligate Lockwood International, Inc. or any of its divisions and/or subsidiaries further process of my application. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release Lockwood International, Inc. from any and all liability for any and all damage that my result from utilization of such information. I also understand and agree that no representative of Lockwood International, Inc. has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized Lockwood International, Inc. representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act and other relevant federal and state laws.”

Date:

By submitting this by email you agree the above

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