Apply for Program Specialist - Lubbock, TX

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Summary
Title:Program Specialist - Lubbock, TX
ID:954-1
Department:Client Services
Contact Information
* Last Name:
* First Name:
Preferred name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Cell/Home Phone:
* Email:
Attachments
* Resume:
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Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Application for Employment at MSB - Program Specialist

Please fill out the application form completely. If questions are not applicable, enter “N/A.” Do not leave questions blank. Be sure to sign the document (eSignature) when completed. Resumes will not be accepted in lieu of applications.

MSB Consulting is an Equal Opportunity Employer committed to providing a diverse environment. We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

* Do you have a valid driver's license?
Yes   No


* Are you eligible to be employed in the United States? (Proof of identity and eligibility will be required upon employment)
Yes   No


* Will you now or in the future require MSB Consulting to commence ("sponsor") an immigration case in order to employ you (for example, H-1B or other employment-based immigration case)? This is sometimes called "sponsorship" for an employment-based visa status.
Yes   No


* Are you at least 18 years or older? (If no, you may be required to provide authorization to work)
Yes   No


* Have you ever worked for this company before?
Yes   No


If yes, please provide details:



EMPLOYMENT DESIRED
* How did you hear about us?
Job Site Search (e.g., Indeed, LinkedIn, etc.)   Recruiter Contacted Me   Employee Referral   Non-Employee Referral   Job Fair   None Are Applicable


* If you are a referral, please provide name of referrer below:


* Type of employment desired
Full-Time   Part-Time   Seasonal   Intern


* Hourly rate/salary desired


* Will you work overtime, if required?
Yes   No


* When would you be available to begin work?


* Are you currently employed?
Yes   No


If so, may we inquire of your present employer?
Yes   No


If presently employed, why are you considering leaving?


* What value would you bring to MSB?


* Why MSB?


* How do you build relationships?

EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School Name & Location Did you Graduate? Degree Received Subjects Studied/Major
*
*
Yes   No
*
*
Yes   No
Yes   No

License/Certification Name Date Issued Date Expires License/Certification Number Issuing Authority

EMPLOYMENT HISTORY

Please input your entire employment history in this section (starting from most recent to least recent), regardless of your resume. Please type in "N/A" for any fields where the information is not applicable or not immediately available.

EMPLOYER 1
Dates Employed Employer Name & Address Employer Phone
From:
*
To:
*
*
*
 
Job Title Supervisor Name & Title May we Contact?
*
*
*
*
Yes   No
Responsibilities Reason for Leaving Salary/Hourly Rate
*
*
Start:
*
End:
*
If supervisory, how many direct reports did you supervise? Status
*
*
Full-Time   Part-Time   Temp   Intern

EMPLOYER 2
Dates Employed Employer Name & Address Employer Phone
From:
*
To:
*
*
*
*
 
Job Title Supervisor Name & Title May we Contact?
*
*
*
*
Yes   No
Responsibilities Reason for Leaving Salary/Hourly Rate
*
*
Start:
*
End:
*
If supervisory, how many direct reports did you supervise? Status
*
*
Full-Time   Part-Time   Temp   Intern

EMPLOYER 3
Dates Employed Employer Name & Address Employer Phone
From:
*
To:
*
*
*
*
 
Job Title Supervisor Name & Title May we Contact?
*
*
*
*
Yes   No
Responsibilities Reason for Leaving Salary/Hourly Rate
*
*
Start:
*
End:
*
If supervisory, how many direct reports did you supervise? Status
*
*
Full-Time   Part-Time   Temp   Intern

* Have you ever been involuntarily discharged or asked to resign from employment?
Yes   No


If yes, please explain:


* Did you receive any discipline in your last 12 months of active employment with your previous employer?
Yes   No


If yes, please explain:


* Have you signed any non-competition or non-solicitation agreement or any other kind of agreement with any other employer that might restrict you from working for MSB (you will be required to furnish a copy of the agreement if you are being considered for hire)?
Yes   No


If yes, please explain:



REFERENCES Please provide two professional references (these individuals must be unrelated to you and with whom you have worked who know your qualifications for this position).

Name Relationship Phone Number Email Address
*
*
*
*
*
*
*
*

AUTHORIZATION

The facts set forth in this application and any supplemental information (including but not limited to information provided in resumes, attachments to this application, interviews, or otherwise) are true and complete to the best of my knowledge. I understand that any misrepresentations, omissions of facts, or incomplete answers during the application process may disqualify me from further consideration for employment. I further understand that, if employed, any misrepresentations or omissions of facts during the application process may be cause for dismissal at any time without prior notice.

I further authorize the listed employers, schools and personal references to give the Company (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have and hereby waive any actions which I may have against either party(ies) for providing a good faith reference.

I expressly agree and understand that, if employed, my employment is not for a specific term, is based on mutual consent and may be terminated by me or the Company with or without notice or cause at any time. I further understand that no oral promise, employer policy, custom, business practice or other procedure (including personnel handbook or any personnel manuals) constitute an employment contract or modification of the at-will employment relationships between me and the Company. I also understand that my at-will employment status with the company may only be altered in an individual case or generally in a writing signed by the owner, president or CEO of the Company.

I understand I may be required to qualify for employment based on additional employment criteria. For example, I may be required to take job-related tests; take a driver’s examination or take a pre-employment drug test. If I am offered employment or start work before any required test is completed, I understand that my employment is contingent on a satisfactory result on all required tests. I authorize the release of any drug/alcohol test to any state or federal authority requesting such information and in response to a valid subpoena or other legal document. I agree to sign any additional forms necessary for drug tests to be conducted.

I understand that I am required to abide by all rules and regulations of the company.

I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.

* Signature (type name):  * Date: 



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