Professional Application for Employment

State Issuing Driver's License*

Driver's License Number*

Date of Birth*

Date

Social Security Number*

Gender*

MaleFemale

Race (choose one or more)*

Ethnicity*

Hispanic/LatinoNot Hispanic/Latino

Have you ever been charged with, convicted of, or received deferred adjudication concerning any criminal charge?*

YesNo

If yes, please explain:

By signing my name below, I hereby affirm that all of this information in this application is true and accurate. I understand if the information provided is untrue or inaccurate or contains falsifications, misrepresentations or omissions of fact it will be grounds for rejection of my application or dismissal from my subsequent employment.

I understand that the Carthage Independent School District is authorized by state law to obtain criminal history record information on applicants the district tends to employ. I authorize the district to update my criminal history record at any time during my employment with Carthage ISD. The information requested in this section is necessary to obtain criminal history record information.

I understand that the information I am providing about age, gender, and ethnicity will not be used to determine eligibility for employment, but will be used solely for the purpose of obtaining criminal history record information, and that the information will be maintained in a file separate and apart from my employment application.

The Carthage Independent School District is an Equal Opportunity Employer and does not discriminate because of age, race, color, creed, religion, disability, gender, sexual orientation or national origin in the educational programs or activities which it operates, including employment therein.