Fillable Printable Correctional Services Application Form - McLennan
Fillable Printable Correctional Services Application Form - McLennan
Correctional Services Application Form - McLennan
McLennan County Community Supervision and Corrections Department
(CSCD- Ad ult Probation Department)
Applicant Information Sheet
McLennan County CSCD is an equal opportunity employer and encourages applications from eligible and qualified
individuals regardless of race, color, religion, sex, national origin, age, or non-disqualifying disability. The following
voluntary information will be used to track the overall effectiveness of the Department’s recruitment efforts. The
information will not be submitted to the hiring administrators or used in the hiring process. You are not required to
complete this sheet to be considered for employment.
Date
Name
Last Name First MI
Address
Street City State Zip Code
Position Applying For: Vacancy Number
Sex: Male
Female
Ethnic Origin (choose only one):
White/Non-Hispanic
Asian/Pacific Islander
Black/Non-Hispanic
American Indian/Alaskan Native
Hispanic
Age:
Under 18
18 – 39
Over 40
United States Veteran:
Yes
No
Source of Referral (Choose only one):
Walk in
Waco Tribune Herald
Job Line
Texas Work Force Commission
County Employee
Other
McLENNAN COUNTY COMMUNITY SUPERVISION
AND CORRECTIONS DEPARTMENT
EMPLOYMENT APPLICATION
ALL QUESTIONS MUST BE ANSWERED
EMPLOYMENT DESIRED
Position applying for
Vacancy Number
Salary desired
Date available
Are you employed now? Yes No
If so, may we contact your present employer?
Yes
No
Have you ever applied with
McLennan County CSCD before?
Yes
No
Position? When?
PERSONAL INFORMATION
Last Name First Name MI
Address City State Zip Code
Driver’s License Number State Expiration Date Check Type of License
Operator C
Commercial B
Chauffeur A
Referred By:
Social Security Number Home Telephone Number (w/Area Code) Cell Telephone Number (w/Area Code)
Are you over 18 years of age? Yes No If not, employment is subject to verification of age.
EDUCATION
High School Attended and Location No. years
completed
Did you Graduate? Yes No
If not, do you have a GED?
Yes
No
College Attended and Location No. years
completed
Major Degree/Certificates
College Attended and Location No. years
completed
Major Degree/Certificates
College Attended and Location No. years
completed
Major Degree/Certificates
Trade, Business or Correspondence School Attended and Location No. years
completed
Degree/Certificates
CITIZENSHIP
Are you a U.S. Citizen?
Yes No
If no, do you have the legal right to work in the U.S.?
Yes No
If not a U.S. Citizen, proof of the right to work in the United States must accompany this application.
U.S. MILITARY SERVICE Yes No if Yes complete below.
Dates of service
(from / to)
Duties
REFERENCES
Name Address Phone
EMPLOYMENT HISTORY
Provide employer information for last 10 years and any other work you feel is relevant to the position you
have applied for. Attach additional sheets if necessary. (ALL QUESTIONS MUST BE ANSWERED)
(1) Present or last employer (Include address) Phone No. (w/Area Code)
Date Started:
Date Left:
Your Title:
Immediate Supervisor: Their Title:
Annual Salary at start:
Annual Salary on leaving:
Reason for leaving:
Your Duties:
(2) Previous employer (Include address) Phone No. (w/Area Code)
Date Started:
Date Left:
Your Title:
Immediate Supervisor: Their Title:
Annual Salary at start:
Annual Salary on leaving:
Reason for leaving:
Your Duties:
(3) Previous employer (Include address) Phone No. (w/Area Code)
Date Started:
Date Left:
Your Title:
Immediate Supervisor: Their Title:
Annual Salary at start:
Annual Salary on leaving:
Reason for leaving:
Your Duties:
(4) Previous employer (Include address) Phone No. (w/Area Code)
Date Started:
Date Left:
Your Title:
Immediate Supervisor: Their Title:
Annual Salary at start:
Annual Salary on leaving:
Reason for leaving:
Your Duties:
(5) Previous employer (Include address) Phone No. (w/Area Code)
Date Started:
Date Left:
Your Title:
Immediate Supervisor: Their Title:
Annual Salary at start:
Annual Salary on leaving:
Reason for leaving:
Your Duties:
(6) Previous employer (Include address) Phone No. (w/Area Code)
Date Started:
Date Left:
Your Title:
Immediate Supervisor: Their Title:
Annual Salary at start:
Annual Salary on leaving:
Reason for leaving:
Your Duties:
(7) Previous employer (Include address) Phone No. (w/Area Code)
Date Started:
Date Left:
Your Title:
Immediate Supervisor: Their Title:
Annual Salary at start:
Annual Salary on leaving:
Reason for leaving:
Your Duties:
SPECIAL SKILLS / QUALIFICATIONS
List all special skills you possess and/or machines or office equipment you can use, such as calculators,
computer equipment, types of software/hardware, etc.
Other courses work applicable to this type of work:
PRE-EMPLOYMENT STATEMENT
I authorize the McLennan County CSCD to make any inquiries they desire regarding my education,
employment, ability, habits and personal character for the purpose of determining my fitness for employment. I
also authorize previous employers, or any other persons to whom the CSCD may refer, to give any and all
information regarding my employment or scholastic record together with any information, personal or otherwise,
and I hereby release such persons and any companies which they represent from all liability or any damages
what so ever in connection with their compliance. I understand that misrepresentation or omission of any
information called for in this application which would affect my application unfavorably, or receipt of
unsatisfactory references may result in termination of my employment without liability to me for salary except as
may have been earned at the time of my termination. If employed I understand that my employment with the
CSCD will be “at will”, meaning that either the CSCD or myself may terminate the employment relationship at
any time, for any reason or no reason at all with or without notice of any kind.
APPLICANT’S SIGNATURE
(If submitted electronically print your name below.) DATE
EQUAL OPPORTUNITY EMPLOYER McLennanCountyCSCDdoesnotdiscriminateonthebasisof
race,color,religion,sex,nationalorigin,ageordisabilityinemploymentorprovisionofservices.
