Application For Texas De Brazil Form – Fill Out and Use This PDF

EMPLOYMENT RECORD

Please indicate previous employment. Start with present or most recent position, including military service. (Use additional sheet if necessary)

PLEASE READ CAREFULLY BEFORE INITIAL/SIGNING. IF YOU HAVE ANY QUESTIONS REGARDING THE FOLLOWING STATEMENTS, PLEASE ASK FOR ASSISTANCE.

INITIALS

__________ I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment.

__________ I understand, where permissible under applicable federal, state, and local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment, and must

receive a negative result before being permitted to commence work with the company. I also may be subject to post-employment drug tests: (1) post-accident; (2) random; or (3) upon reasonable suspicion in accordance with applicable federal, state and local law.

__________ I understand, where permissible under applicable federal, state, and local law, I may be subject to a pre-employment medical examination after receiving a conditional offer of

employment, and must meet the qualiications for the position, with or without reasonable accommodation, before being permitted to commence work with the company.

__________ I certify that the information given by me on this application is true and complete, without any omissions of any kind. I authorize the company and its representatives to contact my

prior employers and all others for the purpose of veriication of the information I have supplied and release same from any liability resulting from the information released. I authorize employers, schools and other persons named on this application to provide any information or transcripts requested.

__________ I understand employment with the company is also contingent on my providing suficient documentation necessary to establish my identity and eligibility to work in the United States.

__________ I expressly understand and agree that, if employed, my employment, having no speciied term, is based upon mutual consent and may be terminated at will, with or without cause, by

either party (the employer or me) without prior notice to the other, unless otherwise prohibited by law.

__________ I understand that no representation, whether oral or written, by any representative or agent of the company, at any time, can constitute an implied or expressed contract of employment.

I further understand no representative or agent of the company has the authority to enter into an agreement for employment for any speciied period of time or to make any change in any policy, procedure, beneit or other terms or condition of employment other than in a document signed by the Director of Human Resources or his/her authorized representative.

__________ I certify, under penalty of perjury, that all of the above information is true and complete, and I understand that any falsiication or omission of information may result in denial of

employment or, if hired, may result in termination regardless of the time lapse before discovery.

MY SIGNATURE IS EVIDENCE THAT I HAVE READ AND AGREE WITH THE ABOVE STATEMENTS.
_______________________________________________________________	_______________________________________________________________	______________________
Applicant’s Name	Applicant’s Signature	Date

*Application is valid for 30 days only, once expired, a new application must be submitted.

JURY WAIVER AGREEMENT

Although the Texas de Brazil believes that our internal complaint resolution procedures should be suficient to resolve any workplace problems that you may have, we recognize that sometimes, notwithstanding everyone’s best efforts, a matter cannot be resolved internally. In those rare instances, we believe that our nation’s judges (such as our federal judges who are appointed by Congress for life and thus are free from any outside bias or inluence) are in the best position to resolve our workplace disputes. Accordingly, we have created this policy which, in effect, says that if you ile a lawsuit, our nation’s judges will decide if we acted correctly or incorrectly. This policy does not take away any of your rights to sue or seek any type of remedy the law allows, it simply provides for a federal or state judge to decide our differences. By signing this agreement you consent to waive your right to a jury trial with respect to any lawsuit you may commence against Texas de Brazil, its afiliates, subsidiaries, divisions, successors, assigns, and purchasers, and the current, former, and future employees, shareholders, oficers, directors and agents thereof (“Texas de Brazil “), relating in any manner to your application for, employment with, or cessation of your employment, or any term and condition of your employment with the Texas de Brazil. Absent signing this Jury Waiver Agreement you would not be hired and/or remain employed by Texas de Brazil. You have the right to consult with counsel of your choosing regarding this Jury Waiver Agreement prior to signing this document.

By signing below you acknowledge that you have had a reasonable period of time to consider this Jury Waiver Agreement and are waiving your right to a jury trial knowingly, voluntarily, and free from duress or coercion.

_______________________________________________________________	_______________________________________________________________	______________________
Applicant’s Name	Applicant’s Signature	Date