JOB APPLICATION - CHANNELVIEW, TX You must have JavaScript enabled to use this form. Position Applying For What shift are you applying for? - Select -DayEveningNightAny Name Phone Number Email Address Mailing Address Address Street Address City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Do you have any relatives currently or previously employed at any Eagle Railcar location? If there are any relatives who have been employed at Eagle Railcar, please list their name, location and whether they are a current or past employee. Who referred you? Are you currently employed? - Select -YesNo How long since your last employment? Highest Level of Education - Select -8th grade or lower9th grade10th grade11th gradeHigh School Graduate1 year of college2 years of college3 years of collegeCollege GraduateGraduate School Have you ever been convicted of a felony? - Select -YesNo If Yes, please explain in the box below. Conviction of crime is not an automatic bar to employment. All circumstances will be considered. Employment Record Employer 1 Please include information and number them as follows: 1) Current Employer 2) Supervisor's Full Name 3) Full Address 4) Zip Code 5) Phone number 6) Position Held 7) What time frame? Month and year. (Example: June/2011- October/2013) 8) Salary: 9) Your Reason for Leaving Employer 2 Please include information and number them as follows: 1) Current Employer 2) Supervisor's Full Name 3) Full Address 4) Zip Code 5) Phone number 6) Position Held 7) What time frame? Month and year. (Example: June/2011- October/2013) 8) Salary: 9) Your Reason for Leaving Employer 3 Please include information and number them as follows: 1) Current Employer 2) Supervisor's Full Name 3) Full Address 4) Zip Code 5) Phone number 6) Position Held 7) What time frame? Month and year. (Example: June/2011- October/2013) 8) Salary: 9) Your Reason for Leaving Please provide 3 references Please include the names and the phone numbers of the 3 references. Military Service Branch From Date To Date Rank at discharge Type of discharge If other than honorable, explain How did you hear about Eagle Railcar Services? How did you hear about Eagle Railcar Services? - Select -Business CardRadioBillboardIndeedLinkedinOther… Enter other… Applicant Statement and Agreement - Please read and check I Agree for each paragraph below. If there is something you do not understand, please ask. I hereby authorize the company to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the prior employers and references I have listed to disclose to the company information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the company, my former employers, and all other persons, corporations, partnerships, and associations from any claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure. I Agree I understand that any job offer is contingent upon a background check and drug screen clearance. I Agree If hired, I understand that I am required to comply with all rules and regulations of the company. I Agree If hired, I understand and agree that my employment with the company is at will and that neither I nor the company is required to continue the employment relationship for any specific term. I Agree I understand that the safety of employees is extremely important to the company and that the company is committed to ensuring a safe working environment. If hired, I understand that I, and every employee, have a responsibility to prevent accidents and injuries by observing all safety procedures and guidelines and following the directions of my site supervisor. I understand and agree to comply with federal, state, and local regulations related to on-the-job safety and health. I Agree I hereby certify that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. I Agree I understand that if I am selected for hire, it will be necessary for me to provide satisfactory evidence of my identity and legal authority to work in the United States. I Agree I understand that if any term, provision, or portion of this Agreement is declared void or unenforceable, it shall be severed, and the remainder of this Agreement shall be enforceable. I Agree I certify that my answers are true and complete to the best of my knowledge. My signature attests to the fact that I have read, understand and agree to the above terms. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. 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