Employee Self Service

Employment Opportunities

TOM GREEN COUNTY
Thank you for your interest in employment with Tom Green County.
To ensure full consideration, please complete your application completely and accurately.
Application instructions: tab through the application; do not "hit" Enter until ready to submit;
check and correct all errors noted by a red asterisk.
TO ASSIST IN THE EVALUATION OF YOUR QUALIFICATIONS, PLEASE ATTACH A RESUME TO YOUR APPLICATION.
Tom Green County is an Equal Opportunity Employer and all applicants will receive consideration
without regard to race, color, religion, national origin, gender, age, or disability.
APPLICANT INFORMATION
Last Name
First Name
Middle Initial
Previous Name
Address
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Additional Phone (xxx-xxx-xxxx)
E-mail Address
SSN (xxx-xx-xxxx)
EMPLOYMENT ELIGIBILITY INFORMATION
Check all that apply to you.
 I am a U.S. citizen.
 I am legally eligible to work in the U.S (Work Visa).
 I have been convicted of, or plead guilty or no contest to, a misdemeanor or felony.
If yes, explain in detail.
AVAILABILITY INFORMATION
Please provide information about when you are available to work.
 Full-time
 Part-time
 Temporary
 Day Shift
 Evening/Night Shift
 Available to Start Work (mm-dd-yy)
DRIVERS LICENSE
Driver's License Number 
Driver's License Type (including Endorsements) 
MISCELLANEOUS INFORMATION
Please provide the following information.
 I am a current employee of Tom Green County.
 I am a former employee of Tom Green County. Date and Department
Name any officer or employee of Tom Green County you or your spouse are related to. 
List languages you speak and read fluently. 
How did you hear about this position?
HIGH SCHOOL INFORMATION
City/State
 Check if you received a High School Diploma
 Check if you received a GED
TECHNICAL/VOCATIONAL SCHOOL
City/State
Name of Course or Program
Date Diploma Received
COLLEGE/UNIVERSITY EDUCATION
State
Name of University/College
Degree Type
Subject Area
Credit Hours Completed
Credit Hours Remaining
Date Graduated (mm-dd-yy)
GPA
Add Another
LICENSES AND CERTIFICATIONS
License or Certification
Specialty
Effective Date
Expiration Date
List TCLEOSE PID# 
EMPLOYMENT HISTORY
Employer Name
Start Date (mm-dd-yy)
End Date (mm-dd-yy)
Current or Last Salary
Address
City
State
Zip Code
Position Title
Supervisor
Phone (xxx-xxx-xxxx)
Describe Specific Job Duties
Reason for Leaving
EMPLOYMENT HISTORY
Employer Name
Start Date (mm-dd-yy)
End Date (mm-dd-yy)
Current or Last Salary
Address
City
State
Zip Code
Position Title
Supervisor
Phone (xxx-xxx-xxxx)
Describe Specific Job Duties
Reason for Leaving
EMPLOYMENT HISTORY
Employer Name
Start Date (mm-dd-yy)
End Date (mm-dd-yy)
Current or Last Salary
Address
City
State
Zip Code
Position Title
Supervisor
Phone (xxx-xxx-xxxx)
Describe Specific Job Duties
Reason for Leaving
Add Another
DEMOGRAPHIC INFORMATION
The information requested is being collected for the purpose of reporting statistics to Federal and
State agencies and will not be provided to personnel conducting interviews or making employment
decisions.
Gender
Race
Date of Birth (mm-dd-yyyy)
Marital Status
Veteran Status
REFERENCES
Name
Address
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Occupation/Title
REFERENCES
Name
Address
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Occupation/Title
REFERENCES
Name
Address
City
State
Zip Code
Phone (xxx-xxx-xxxx)
Occupation/Title
RESUME OR OTHER FILE ATTACHMENT
Attach Resume or Other File 
APPLICANT ACKNOWLEDGEMENT
* I certify that the statements and information contained herein are true, complete, and correct
to the best of my knowledge.
* I certify that I am currently eligible to work in the United States.
* I authorize the release to Tom Green County or its authorized representative
of any and all employment, educational, military, driver's license, criminal, credit, or other
job-related records as needed to determine your eligibiility for employment.
* I understand that, if selected for an interview, true copies of all degrees, certificates, or
licenses listed on this application will be provided if required.
* I understand and agree that, if hired, my employment is for no definite period and may be
terminated at ay time.
* I understand that if my job requires me to operate a County vehicle and if I become uninsurable
by the County's insurance carrier that my employment may be terminated.
Check if you acknowledge and agree to the statements above.  
Date (mm-dd-yy)