About Us
Eye Care Services
Eye Q
Insurance
Contact Us
- Book Appointment
- Health History Form

About Us
Eye Care Services
Eye Q
Insurance
Contact Us
- Book Appointment
- Health History Form

Apply

Apply

Step 1 of 4 - Personal Information

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Name*
First Last
Phone*
Email*
Address
Street Address Address Line 2 City State ZIP Code
Position Sought
Select One
- Part Time
- Full Time
Days and Hours Available
Starting Date
Desired Starting Wage
Do you currently wear corrective lenses?
Please check all that apply.
- Glasses
- Contacts
- None
Do you have any misdemeanor convictions?*
- Yes
- No
Do you have any felony convictions?*
- Yes
- No
Please Explain.

Computer Skills
Typing (words per minute)
Other business machines/skills?
Are you fluent in any languages other than English?
- Yes
- No
Please list them.
Activities enjoyed (civic, athletic, hobbies, etc.)

Education

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(HS, College, etc)	School Name	Major/Degree	Dates Attended	Graduation Date

Long term career objective
Short term goals for the next two years
What are your expectations for this job?
What is your reason for applying to this type of business?

Employment History

Employer Name	City, State	Actions

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I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is no definite period and may be terminated any time without any previous notice.*
I agree to the privacy policy.
Signature

Eyes of Texas
2320 E Villa Maria Rd
Bryan, TX 77802
(979)-77-TEXAS (83927)
youreyesoftexas@gmail.com

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Supervisor Name
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Dates of Employment
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