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Please Note: Complete the application to the best of your ability. All information will be considered confidential. We consider all applicants without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status. This application does not constitute an employment agreement. BVCAA, Inc. is an At-Will employer and may terminate with or without notice for cause or without cause. This application may be rejected if it is not completed in its entirety. BVCAA, Inc. reserves the right to reject this application or terminate employment if the information contained in the application is found to be false or misleading.

INSTRUCTIONS TO APPLICANTS
Please complete all sections of the application. Incomplete application will not be considered for employment.

Personal Information

First Name:

Last Name:

Street Address:

Apartment Number?:
City:

State:
Zip Code:

Home Number:

Cell Number:

Work Number:

Best Time to contact you?:

Preferred Contact Method:

Email Address:

How were you referred to us?:
NewspaperWebsiteCurrent employeeFriend or relative
Name of the person who referred you?:

Have you ever been employed by BVCAA, Inc. before?:
YesNo
If so, When?:

And where?:

Are you related to a current board member of BVCAA Board of Trustees or any current employee
of BVCAA?
YesNo
If yes, please state their name and your relationship to that person(s):

Work Desired

Indicate the position for which you are applying: (If your are applying for more that one job position and/or location, please note this below.)

Job Location?:
AdministrationHuman ResourcesHP-ABCHP-Bryan/College StationHP-CaldwellHP-CentervilleHP-FranklinHP-HearneHP-HempsteadHP-MadisonvilleHP-Mary Lake DentalHP-MemorialHP-NavasotaHP-Somerville
Full Time or Part Time?:
Full TimePart TimeTemporary
If part-time, specify days/hours wanted:


Desired Salary?:

Annually or Hourly?:
AnnualHourly

Date Available to start:

General Information

Are you legally authorized to work in the United States?:
YesNo
Are you under the age of 18?:
YesNo
Do you know of any reason why you cannot perform the essential functions of the job for which you are applying with or without accommodations?:
YesNo
Please indicate any accommodations required:

*Have you ever been charged or convicted of a crime?
*A conviction record may not necessarily bar an applicant from employment. Facts such as length of time since the conviction and type of conviction will be considered.
YesNo
If yes, Date?:

Nature of the crime:

Circumstances:

Skills

Business machines you can operate:

Typing Speed in Words Per Minute:
10 Key Proficient? : YesNo
Software Knowledge: Please list all computer programs you are familiar with and your proficiency in each.

Languages: Please list any languages you speak, read, or write.

Education

High School:
Name:
Address:
City:
State:
Number Of Years completed :
Degree, Major, or Course of Study:

College:
Name:
Address:
City:
State:
Number Of Years completed :
Degree, Major, or Course of Study:

Graduate School:
Name:
Address:
City:
State:
Number Of Years completed :
Degree, Major, or Course of Study:

Trade, Business, Night, or Correspondence School:
Name:
Address:
City:
State:
Number Of Years completed :
Degree, Major, or Course of Study:

Others:

Please indicate any other information that you think would be helpful to us in considering you for employment, such as additional work/volunteer/training experience, activities, articles/books published, accomplishments, etc. (Please exclude all information indicative of age, sex, race, religion, color, national origin, or disability).

Military Experience

Have you ever been in the U.S. Armed Forces?: YesNo
If yes, Which Branch?:
Rank at Seperation:
Describe your duties:

Employment History

List employer(s) for your work experience(s) beginning with your present or most recent.

Most Recent
Employer:
Address:
City:
State:
Telephone Number:
Employment dates:
Start:
End:
Please check this box if you are still currently employed at this job:
YesNo
Salary:
Start: $
End: $
Yearly or Hourly:
YearlyHourly
Supervisor's Name:
Supervisor's Number/Extention:
Job Title:
Reason for leaving?:
May we contact this employer?:YesNo
Job duties?:

Employer:
Address:
City:
State:
Telephone Number:
Employment dates:
Start:
End:
Please check this box if you are still currently employed at this job:
YesNo
Salary:
Start: $
End: $
Yearly or Hourly:
YearlyHourly
Supervisor's Name:
Supervisor's Number/Extention:
Job Title:
Reason for leaving?:
May we contact this employer?:YesNo
Job duties?:

Employer:
Address:
City:
State:
Telephone Number:
Employment dates:
Start:
End:
Please check this box if you are still currently employed at this job:
YesNo
Salary:
Start: $
End: $
Yearly or Hourly:
YearlyHourly
Supervisor's Name:
Supervisor's Number/Extention:
Job Title:
Reason for leaving?:
May we contact this employer?:YesNo
Job duties?:

References

Name:
Phone Number:
Relationship:

Name:
Phone Number:
Relationship:

Name:
Phone Number:
Relationship:

Cover Letter and Resume
If your have a resume or cover letter to upload, please do so here.
Acceptable Formats are .doc, .docx, .pdf, and .txt. Size limit is 5 MB. Thank you.

Cover Letter:
Resume:

Applicant's Statement

The answers and information presented in this application are complete and accurate. I authorize BVCAA, Inc. to investigate all information presented in this application or interview(s) in the consideration of an employment decision for the position(s) for which I have applied.

I understand and acknowledge that BVCAA, Inc. is an At-Will employer and that if hired, as an employee, I may resign at any time and that BVCAA, Inc. may terminate my employment at any time with or without cause. I understand that At-Will status can only be changed through a written agreement duly authorized and executed by the Executive Director of BVCAA, Inc. Nothing in this application or any Agency document or statement will be considered as creating guaranteed or continued employment. I further understand and acknowledge that false or misleading information provided in this application or interview(s) may result in rejection of this application or termination of employment if I am hired.


Please input your name below. This e-signature will be considered the same as a handwritten signature.

Signature of Applicant:
Date:

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