Browse our website

Job Application

Are You Currently Employed?

If yes, may we inquire of your present employer?

Have you ever been employed here before?

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release to the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

I, [applicant name] have applied for employment with TCC. I understand that as a condition for my being considered for employment at the position for which I am applying, I will be required to undergo drug and /or alcohol testing. I willingly agree to this testing and understand that if my test results are positive, I shall not be considered further by TCC for this position. TCC does not tolerate the use of alcohol or non-prescription drugs on company premises or job sites. If an employee is suspected of working while under the influence of illegal drugs and/or alcohol, the employee will be suspended and required to submit to a drug and/or alcohol test. Suspension shall be without pay until the results of the test are obtained by TCC. All employees and prospective employees are hereby notified that test results may be used in arbitration, administrative hearings and court cases arising as a result of the employees drug testing. In all other instances, every reasonable effort will be made by TCC to protect the confidentiality of the information. I hereby authorize any laboratory, physician or medical professional retained by TCC to conduct such testing and to provide the results to TCC. I further release TCC and any person affiliated with TCC and any such institution or person conducting the testing, from liability therefore.

Are you aware of any condition or injury that might impair or limit your ability to work for this company?

I have read and fully understand the above.

1208.1 Employer's inquiry into employee's previous injury claims: Forfeiture of benefits Nothing in this Title shall prohibit an employer from inquiring about previous injuries, disabilities, or other medical conditions and the employee shall answer truthfully; failure to answer truthfully shall result in the employee's forfeiture of benefits under this chapter. Provided said failure to answer directly relates to the medical condition for which a claim for benefits is made of affects the employer's ability to receive reimbursement from the second injury fund. This section shall not be enforceable unless the written form on which the inquiries about previous medical conditions are made contains a notice advising the employee that his failure to answer truthfully may result in his forfeiture of workers' compensation benefits under R.S. 1308:1. Such notice shall be prominently displayed in bold faced block lettering of no less that ten point type.

Have you ever had surgery to any part of your body?

Have you ever received treatment for your back, neck, knees, or lower extremities from a doctor, chiropractor, therapist, or other health care provider?

Have you ever had any injury which required you to miss time from work?

By checking "Yes" I acknowledge that I am the individual stated on this application, I have read all contents, and given accurate information. I also consent to the use of this information for background checks.