NORTHEAST TEXAS POWER,LTD.
P.O. Box 557
102 N. 1·30 Service Rd.
Cumby, Texas 75433
Office: (903) 994-4200       Fax: (903) 994-2747

APPLICATION FOR EMPLOYMENT

PERSONAL INFORMATION

DATE ________________________  SOCIAL SECURITY # _______________________________________

NAME  ____________________________________________________________________________________________________________
                                            LAST                                                                      FIRST                                                  MIDDLE

PRESENT ADDRESS _______________________________________________________________________________________________
                                                                             STREET                                                       CITY                                        STATE / ZlP

MAILING ADDRESS ________________________________________________________________________________________________
                                                                             STREET                                                       CITY                                        STATE / ZlP

DATE OF BIRTH __________________________     PHONE NUMBER _____________________________

DRIVERS LICENSE # ____________________________     REFERRED BY ___________________________________________________
DO YOU HAVE A CDL? _____________________________________________________________________

EMPLOYMENT DESIRED

POSITON __________________________________   DATE AVAILABLE ________________ SALARY DESIRED ___________________

ARE YOU EMPLOYED NOW?                                                                            YES _______     NO _______

IF YES, MAY WE CONTACT YOUR PRESENT EMPLOYER?                      YES _______     NO _______

HAVE YOU EVER WORKED FOR THIS COMPANY BEFORE?                    YES _______    NO _______

IF YES, WHEN? ____________________________________________________________________________________________________

DO YOU HAVE ANY RELATIVES OR FRIENDS WORKING FOR THIS COMPANY?

IF YES, WHO? _____________________________________________________________________________________________________

FORMER EMPLOYERS

EMPLOYER NAME _________________________________________________   POSITION ____________________________________

EMPLOYER ADDRESS ______________________________________________________________________________________________

EMPLOYED FROM _____________________   T0 _______________________   SALARY _______________________________________

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EMPLOYER NAME _________________________________________________   POSITION ____________________________________

EMPLOYER ADDRESS ______________________________________________________________________________________________

EMPLOYED FROM _____________________   T0 _______________________   SALARY _______________________________________
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EMPLOYER NAME _________________________________________________   POSITION ____________________________________

EMPLOYER ADDRESS ______________________________________________________________________________________________

EMPLOYED FROM _____________________   T0 _______________________   SALARY _______________________________________
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EDUCATION
                                                                            Name of School                                             Last Year Completed          Graduate?

HIGH SCHOOL __________________________________________________________            1   2    3    4                       Y    N

COLLEGE _______________________________________________________________            1   2    3    4                       Y    N

TRADE / BUSINESS SCHOOL ______________________________________________          1   2    3    4                       Y    N

PLEASE LIST ANY JOB RELATED SKILLS ____________________________________________________________________________

IN CASE OF EMERGENCY, NOTIFY: _________________________________________________________________________________

AUTHORIZATION

I AUTHORIZE INVESTIGATION ON ALL STATEMENTS IN THIS APPLICATION.  I UNDERSTAND THAT MISREPRESENTATION OF INFORMATION REQUESTED IS CAUSE FOR DISMISSAL.  FURTHER, I UNDERSTAND, AND AGREE, THAT MY EMPLOYMENT IS FOR NO DEFINITE PERIOD, AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT ANY PRIOR NOTICE.

SIGNATURE __________________________________________________________  DATE ___________________________________