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ADDITIONAL INFORMATION

(Check Specialized Skills)

Microsoft Word_______                      Microsoft Excel_______                  Microsoft Office_______
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Windows Version_______             Ten-Key_______           Typing WPM_______         FAX_______
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Multi-line Phone System_____       Other:________________________________________________
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PERSONAL REFERENCES

(Not Relatives or Employers)

               NAME:                                                ADDRESS:                                                    TELEPHONE#
1._________________________________________________________________________________
2._________________________________________________________________________________
3._________________________________________________________________________________
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AGREEMENT

I certify that answers given herein are true and complete to the best of my knowledge.  I authorize investigation of all statements contained in this application as necessary in arriving at an employment decision.  I further authorize employers named in this application to release information to Taylor County concerning my previous employment records and to give a statement concerning my on-the-job performance.  It is my understanding that the personal references named in this application may be contacted and asked to give a statement and information concerning my character and moral turpitude.  In return for Taylor County considering this application, I give my permission for Taylor County to investigate my personal and employment history.  I understand that Taylor County is an "at-will" employer.  I also understand that Taylor County's acceptance of this application in no way guarantee's my employment or that I will be interviewed.   In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.  I understand also, that I am required to abide by all rules and regulations of Taylor County.

                 _______________________________________                  ____________________

                                       Sign Here                                                             Date
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