Career Application

Career Application

Questions? Give us a call: (713) 538-1800
Full Name *

First Name Last Name
Date of Birth *

Month Day Year
Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *
Email Address *
Position Applying For *
Desired Salary *
Enter an hourly rate (/hr) or yearly salary (/yr).
Date Available to Begin Work *

Month Day Year
Are you a U.S. citizen? *

Yes No
Social Security Number
Are you authorized to work in the U.S.?

Yes No
Have you worked for Qbits before? *

Yes No
When did you work for Qbits, and what were your responsibilities?
Have you ever been convicted of a felony? *

Yes No
Please explain your conviction in detail.
Education
Have you graduated from high school? *

Yes No Obtained GED
High School
Address

Street Address

Street Address Line 2

City State

Zip Code
What level of higher education have you achieved? *

None Associate Degree Bachelor's Degree Master's Degree Doctoral Degree
College or University
Degree Earned
Address

Street Address

Street Address Line 2

City State

Zip Code
Add another college or university
College of University
Degree Earned
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Add another college or university
College or University
Degree Earned
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
References

List a minimum of three references. Add up to two additional references.
Name *

First Name Last Name
Relationship to You
Phone Number *
Company
Name *

First Name Last Name
Relationship to You
Phone Number *
Company
Name *

First Name Last Name
Relationship to You
Phone Number *
Company
Add another reference
Name

First Name Last Name
Relationship to You
Phone Number
Company
Add another reference
Name

First Name Last Name
Relationship to You
Phone Number
Company
Employment History

List a minimum of three employers. Add up to two additional employers.
Company *
Job Title *
Job Responsibilities *
Date Started *

Month Day Year
Date Ended *

Month Day Year
Reason for Leaving *
Supervisor

First Name Last Name
May we contact this person as a reference?

Yes No
Phone Number
Company *
Job Title *
Job Responsibilities *
Date Started *

Month Day Year
Date Ended *

Month Day Year
Reason for Leaving *
Supervisor

First Name Last Name
May we contact this person as a reference?

Yes No
Phone Number
Company *
Job Title *
Job Responsibilities *
Date Started *

Month Day Year
Date Ended *

Month Day Year
Reason for Leaving *
Supervisor

First Name Last Name
May we contact this person as a reference?

Yes No
Phone Number
Add another job
Company
Job Title
Job Responsibilities
Date Started

Month Day Year
Date Ended

Month Day Year
Reason for Leaving
Supervisor

First Name Last Name
May we contact this person as a reference?

Yes No
Phone Number
Add another job
Company
Job Title
Job Responsibilities
Date Started

Month Day Year
Date Ended

Month Day Year
Reason for Leaving
Supervisor

First Name Last Name
May we contact this person as a reference?

Yes No
Phone Number
Have you served in the United States Military? *

Yes No Currently serving
Branch
Date Enlisted

Month Day Year
Date Discharged

Month Day Year
Type of Discharge
Please explain the nature of your discharge.
Rank at Discharge
Please upload your résumé. *
Signature *

I certify that my answers are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary for arriving at an employment decision. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Clear
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Career Application

Education

References

Employment History