MERCHCO SERVICES, INC.
140 HEIMER RD SUITE 500
SAN ANTONIO, TX 78232
Ph. 210-581-8610 Fax. 210-581-8611
 
We are an Equal Opportunity Employer
Date
Name *

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Present Address *
Zip*
City*
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Cell Phone*
Home Phone
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Employment Desired

Position(s) applying for*
Desired rate of pay ($)

Personal Information

Have you ever applied to or worked for our Company before?
If yes, when?
How did you learn about our company? *
If hired, would you have a reliable means of transportation to and from work?
Are you available to travel out of town overnight for up to four weeks at a time?
When traveling, are you willing to share a room with a coworker?
Are you at least 18 years old? (If under 18, hire is subject to verification that you are of minimum legal age.)
If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country ?
Are you able to perform the essential functions of the job for which you are applying, either with or without reasonable accommodation ?
If no, describe the functions that cannot be performed.
(Note: We comply with the ADA and consider reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)

Employment History

List below all present and past employment starting with your most recent employer (last five years is sufficient). Account for all periods of unemployment.
You must complete this section even if attaching a resume.

Dates of Employment

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Name & Address of Employer

Position Title & Responsibilities

Supervisor & Phone Number

Reason for Leaving

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Dates of Employment

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Name & Address of Employer

Position Title & Responsibilities

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Reason for Leaving

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Dates of Employment

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Name & Address of Employer

Position Title & Responsibilities

Supervisor & Phone Number

Reason for Leaving

 

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Dates of Employment

From:

To :

Name & Address of Employer

Position Title & Responsibilities

Supervisor & Phone Number

Reason for Leaving

 

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Dates of Employment

From:

To :

Name & Address of Employer

Position Title & Responsibilities

Supervisor & Phone Number

Reason for Leaving

 

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Tell us more about your skills, training and experience including anyone you may know who works here :
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Please Read Carefully , check the box for Each Paragraph and Sign Below
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and 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 untruthfulness, 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 hereby authorize MERCHCO SERVICES, INC. to thoroughly investigate my references, work record, education, professional credentials, and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the Company any and all letters, reports and other 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 and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
 
I understand that nothing contained in the application, or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the Company. In addition, I understand and agree that if I am employed, my employment is “at-will” – that is, it is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the Company and that no promises or representations contrary to the foregoing are binding on the Company unless made in writing and signed by me and the Company’s designated representative.
 
I understand an offer of employment may be made contingent on passing a job-related physical examination. I agree to submit to a controlled substances screening and physical examination by the Company’s designated medical practitioner and at the Company’s expense upon receiving a conditional offer of employment from the Company.
 
Should a search of public records (including records documenting an arrest, indictment, conviction, civil judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by the Company, I am entitled to copies of any such public records obtained by the Company unless I mark the check box below. If I am not hired as a result of such information, I am entitled to a copy of any such records even though I have checked the box below.
 
I waive receipt of a copy of any public record described in the paragraph above.
I hereby certify that I have not knowingly withheld any information that might adversely affect my chance for employment and that the answers given by me are true and correct to the best of my knowledge.
Date*:
Applicant’s Signature*