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Employment InquiryChieftain2025-04-08T15:45:05-05:00

Employment Inquiry

Step 1 of 4

25%

Your Personal Information

Your Name(Required)

First Name Middle Name Last Name

Your Email Address(Required)

Enter Your Email Confirm Email

Address(Required)

Address Line 1 Address Line 2 City State ZIP Code

Your Phone(Required)

Best Time To Contact You

Do You Have a Valid License?(Required)

Yes

No

Type of Work Desired

Hours You Are Available for Work(Required)

Please tell us what hours you are available for work each day of the week.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Have You Applied With Us Before?(Required)

Yes

No

If "Yes", Then When?

Education and Certifications

Did You Attend High School?(Required)

Yes

No

High School Name(s) and Location(s)

School Name

School Address

How Many Years Did You Attend High School?

Subject(s) Studied

Did You Graduate?

Yes

No

Did You Attend College?(Required)

Yes

No

College Name(s) and Location(s)

College Name

College Address

How Many Years Did You Attend College?

Subject(s) Studied

Did You Graduate?

Yes

No

Did You Attend a Trade School?(Required)

Yes

No

Trade School Name(s) and Location(s)

School Name

School Address

How Many Years Did You Attend Trade School?

Subject(s) Studied

Did You Graduate?

Yes

No

Employment History

Most Recent Employer(Required)

Please list your current employer, the date you started working for them and the position you hold.

Employer

Phone

Starting Date

Ending Date

Most Recent Employer Continued(Required)

Please list your the position you held, the name of your Supervisor, their title, and phone number.

Position

Supervisor

Supervisor's Title

Supervisor's Phone

May We Contact This Employer?(Required)

Yes

No

Reason To Not Contact(Required)

2nd Most Recent Employer(Required)

Please list your the previous position you held, the name of your previous Supervisor, their title, and phone number.

Employer

Starting Date

Ending Date

Phone

2nd Employer Continued(Required)

Please list your current employer, the date you started working for them and the position you hold.

Position

Supervisor

Supervisor's Title

Supervisor's Phone

May We Contact This Employer?(Required)

Yes

No

Reason To Not Contact(Required)

3rd Most Recent Employer(Required)

Please list your previous employers, the dates you worked and the position you held

Employer

Starting Date

Ending Date

Phone

3rd Employer Continued(Required)

Please list your the previous position you held, the name of your previous Supervisor, their title, and phone number.

Position

Supervisor

Supervisor's Title

Supervisor's Phone

May We Contact This Employer?(Required)

Yes

No

Reason To Not Contact(Required)

Personal References

References #1(Required)

Please provide us with your reference's Full Name, Phone Number, and Email

Reference Name

Phone

Email

References #2(Required)

Please provide us with your reference's Full Name, Phone Number, and Email

Reference Name

Phone

Email

References #3(Required)

Please provide us with your reference's Full Name, Phone Number, and Email

Reference Name

Phone

Email

Tell Us About Yourself

Tell us about any special skills, training, or other details about yourself that you'd like for us to know.

Have You Ever Been Convicted of a Felony?(Required)

Yes

No

Please Provide the Details(Required)

Upload Your Resume

Upload your resume in .pdf, .doc or .docx format

Accepted file types: pdf, doc, docx, Max. file size: 25 MB.

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Jay Young Wolfforth

Jay Young Lubbock

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Wolfforth, TX 79382
(806) 783-8318

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117-82nd St.
Lubbock, TX 79404
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