Thank you for your interest in SOUTHWEST FOUNDATION FOR BIOMEDICAL RESEARCH (SFBR)
PLEASE READ BEFORE FILLING OUT THE APPLICATION
YOU MUST BE 18 YEARS OLD OR OLDER TO WORK OR VOLUNTEER AT SFBR
COMPLETE APPLICATION AS PER THE INSTRUCTIONS BELOW
Incomplete Applications WILL NOT Be Considered
Only ONE (1) Application Is Required For ALL Positions
 It is necessary to complete the “position or kind of work desired” block in order for us to know the position you
are applying for. Be specific. An answer of “Open” or “Anything” is not acceptable.
 A minimum salary indication is necessary in order for us to determine if a particular position meets your
requirements. Do not leave this space blank and do NOT write “Open” or “Negotiable.”
 Include your last ten (or more) years of work history. Please DO NOT WRITE “SEE RESUME”
 Please complete ALL blocks on the application. It is important that we have names and telephone numbers of
former and present supervisor(s) and the reason for leaving or wanting to leave a position. WE DO CHECK
REFERENCES before offering a position.
 Some clerical positions at Southwest Foundation require testing. Your application will be reviewed, and you will be
scheduled for testing, if applicable. (Testing is conducted for certain positions and is not intended as a
measure of intelligence, but as a prediction of ability to perform a job.) Passing a required test is not a
guarantee of an interview. The testing is a part of the screening process.
 Some positions may require an employee to drive a motor vehicle on SFBR business. You must have a VALID
driver’s license and write your driver’s license number on your application.
 For positions that require a Bachelor’s degree, or higher level of education, a copy of your transcript will be
required.
 Applicants with a Doctorate are generally considered only for positions requiring a doctoral degree.
 Applicants for non-doctoral positions whose highest level of education (i.e., high school diploma, college degree,
etc.) is from a non-U.S. educational institution must provide educational equivalency determination documents.
Suggested Credentialing Companies: CEI Education Specialists, www.ceiespecs.com; Foreign Credentials
Service of America, www.fcsa.biz; The Knowledge Company, www.knowledgecompany.com
When you have completed the application, go to www.sfbr.org and find the listing for the job you seek. Select
the option “APPLY ONLINE NOW” and upload your completed application, resume, and cover letter.
We do NOT contact applicants unless we need further information or wish to interview you. Your application
will remain active for one year. During this time, your application will be considered for any positions for which
you qualify and which meet your salary requirements. You may reactivate your application at the end of the oneyear period by completing a new application.
SFBR Form 39 (rev. March 2010)
SOUTHWEST FOUNDATION FOR BIOMEDICAL RESEARCH
P.O. Box 760549 (W. Loop 410 at Military Drive)
San Antonio, Texas 78245-0549
For Office Use Only
Log Number
RECEIVED
ACK-JOB# LTR#
DATE
APPLICATION FOR EMPLOYMENT
(Please complete using Adobe Acrobat Reader or
print out and complete in own handwriting with ink)
Name
Last
Present
Address
Number & Street
First
Middle Initial
Other Name(s) Used with Schools, References or Employers
City
State
Telephone(s) where you can be reached:
Social Security Number:
Are you licensed to drive a motor vehicle?
Are you a U.S. Citizen or Permanent Resident of
U.S.?
Are you 18 years of age or older?
Are you now awaiting trial for or have you ever
plead guilty or no contest to, or been convicted
of any crime other than a minor traffic violation?
[
[
[
[
] Yes
] No
] Yes
]
In what state?
Drivers License Number:
[
[
[
[
] Yes
] No
] Yes
] No
If not, what is your date of birth?
If not, do you have a legal right to
work in the U.S.?
[ ] Yes
[ ] No
If yes,
explain:
If yes, give date and nature.
Position or kind of work desired:
Are you seeking:
Zip
Any other kind of work desired?
Full time work [ ]
Part time work [ ]
Temporary or summer work [ ]
When can you start work?
If you are seeking part time work, list days and times you are available to work:
Pay expected (we must have a general idea of your requirements):
Have you worked here before?
[ ] Yes [ ] No
Who referred you to us?
Have you applied here before?
[ ] Yes [ ] No
Do you have relatives or friends working here?
[ ] Yes [ ] No
If so, give name(s):
List references we may contact. We prefer business associates, past supervisors, or faculty. No relatives, please.
Name
Mailing Address – Street, City, Zip
Daytime Telephone
Occupation or Title
EDUCATION
High school last attended and calendar year last attended:
Are you a high school graduate?
[ ] Yes [ ] No
If no, do you have a GED equivalency:
[ ] Yes [ ] No
If no, please indicate highest grade completed:
Type of
School
Name and Location of Institution
Degree Field or
Major Course
of Study
Diploma, Degree
or Certification
Received
Did You
Academic Credit
Graduate?/ Last Earned (If no degree)
Year Attended
# of semester hrs
Colleges or
Universities
Business,
tech., trade
or formal
job related
military
schools
SFBR Form 39 (rev. March 2010)
EMPLOYMENT HISTORY -
Start with your present or last position and work back. If additional spaces are needed to list employment record,
use the continuation sheet that follows this page. Include military service as a period of employment.
Current or Last Employer
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
per
Title
Name and title of immediate supervisor
Job
duties
Reason for leaving/wanting to leave if presently
employed
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
per
Title
Name and title of immediate supervisor
Job
duties
Reason for leaving
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
per
Title
Name and title of immediate supervisor
Job
duties
Reason for leaving
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
per
Title
Name and title of immediate supervisor
Job
duties
Reason for leaving
We may contact the above employers. Please indicate
any you do not want us to contact and reason:
Were you ever discharged or asked to resign from a position?
[ ] Yes
[ ] No
If yes,
explain:
Please indicate any special skills or qualifications you have which are not shown above such as licenses, technical certifications, etc. If applicable,
attach transcripts, letters of recommendation, licenses or certificates which will assist in establishing your qualifications for employment. Material
attached to this application cannot be returned so the use of photocopies is suggested.
Date:
Signature of Applicant:
EQUAL OPPORTUNITY EMPLOYER, M/F
Applicants will receive consideration without discrimination because of race, color, religion, sex, age, national origin or disability.
SFBR Form 39 (rev. March 2010)
EMPLOYMENT HISTORY - Continuation Sheet. Use ONLY if you have not already accounted for the most current 10 years of your
employment.
Name of firm or organization
From
To
Final or present salary
No. hrs worked
per week:
Month
Year
Month
Year
Street Address
$
per
City, State, and Zip
Telephone
Title
Name and title of immediate supervisor
Job
duties
Reason for leaving
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
Name and title of immediate supervisor
per
Title
Job
duties
Reason for leaving
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
Name and title of immediate supervisor
per
Title
Job
duties
Reason for leaving
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
Name and title of immediate supervisor
per
Title
Job
duties
Reason for leaving
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
Name and title of immediate supervisor
per
Title
Job
duties
Reason for leaving
Name of firm or organization
From
Month
Year
To
Month
Final or present salary
Year
No. hrs worked
per week:
Street Address
$
City, State, and Zip
Telephone
Name and title of immediate supervisor
per
Title
Job
duties
Reason for leaving
Date:
Signature of Applicant:
SFBR Form 39 (rev. March 2010)
SOUTHWEST FOUNDATION FOR BIOMEDICAL RESEARCH
AUTHORIZATION FOR RELEASE OF INFORMATION
PLEASE REVIEW AND SIGN WHERE INDICATED
APPLICANT PROCESS


Southwest Foundation may not interview all applicants for vacant positions. Those applicants to be interviewed will be contacted
by SFBR. Applicants will be considered for up to 1 year following receipt of application materials. Those applicants who wish to
be considered after that period must submit a new application to SFBR.
APPLICATION VERIFICATION
I verify that all information provided on this application, exhibits and resumes submitted to SFBR is true, correct and complete. I
have not withheld any information requested by SFBR. I have accounted for all my training, work experience and other
information requested on this application. I understand that any false, misleading, incomplete, or omitted information on this
application, exhibits or resumes will result in rejection of my application or termination of my employment, whenever discovered.

Permission is hereby granted to SFBR and its agents to investigate the information set out on this application, exhibits and
resumes, and to investigate my suitability for employment. I agree to furnish additional information if requested by SFBR or its
agents. I release SFBR, its agents and all other persons or organizations conducting the investigation or furnishing information
about me from claims, liabilities and damages.

Permission is hereby granted to inquire about and obtain academic records from educational institutions, to inquire of references,
to inquire about employment with previous employers named herein, to obtain my driving records, verify licensure/certifications,
and to use a copy of this authorization for release as necessary.

If I am employed by SFBR, I agree to submit to testing for drugs, a physical examination, and medical monitoring and inoculation
programs as may be required by my work at no expense to me. I also agree to execute an agreement concerning patent
assignments, releases of confidential business information and a publicity authorization. I understand that employment is at will
unless altered in writing.

I understand that employment requires that I provide documents satisfactory to SFBR to establish my personal identity and
authority for my employment in the United States as provided by the Immigration Reform and Control Act of 1986.

I understand that this application is not intended as a job offer or an employment contract for any time period. Any employment
can be terminated at any time by SFBR or me without notice or requirement of cause. I understand that the position being applied
for requires reliable attendance and dependable performance, and that I may be required to work various shifts and schedules as
directed by my supervisor. If employed, I understand I must comply with SFBR policies, rules and procedures as modified from
time to time.
RELEASE
I hereby authorize any prior employers to provide such information concerning my employment with them as may be requested by
SFBR, and also authorize the Registrar/Placement Office of all educational institutions attended to release an official copy of my
transcripts and, if available, faculty appraisals. I also authorize any appropriate licensing board to release complete information
concerning my licensure status and licensure history.
Print Name (Full Name)
Signature of Applicant (Full
Name)
Date of Birth (month/day/year)
Social Security Number
Date Applied
SFBR Form 39 (rev. March 2010)
Southwest Foundation for Biomedical Research
Equal Employment Opportunity Information Request
As a government contractor, Southwest Foundation for Biomedical Research is subject to Executive Order 11246, as amended; Section 402 of the Vietnam
Era Veterans Readjustment Assistance Act of 1974; Section 503 of the Rehabilitation Act of 1973 and Section 1215 of the Veterans Employment
Opportunities Act of 1998. All of these require government contractors to take affirmative action to employ and advance in employment qualified disabled
individuals, qualified special disabled veterans, veterans of the Vietnam Era and other eligible veterans.
We request your voluntary completion of the following questionnaire to be used ONLY for the purpose of monitoring the success of our Affirmative Action
Plan. This information will not be used to discriminate against or to show preference for any applicant in the hiring decision and is not a part of your
application for employment. Your immediate attention is requested.
NAME:
BIRTHDATE:
CITIZENSHIP: U.S.
SEX:
SOCIAL SECURITY NUMBER:
[ ] Yes [ ] No
(Month, day, year)
OTHER (SPECIFY COUNTRY):
RACE/ETHNIC DATA: (Check One)
1[ ]
American Indian or Alaska Native (Not Hispanic or Latino) - A person having origins in any of the original peoples of North America
and South America (including Central America), and who maintains tribal affiliation or community attachment.
2[ ]
Asian (Not Hispanic or Latino) - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
Subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and
Vietnam.
3[ ]
Black or African American (Not Hispanic or Latino) - A person having origins in any of the black racial groups of Africa.
4[ ]
Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino) - A person having origins in any of the peoples of Hawaii, Guam,
Samoa, or other Pacific Islands.
5[ ]
White (Not Hispanic or Latino) - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
6[ ]
Hispanic or Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin
regardless of race.
7[ ]
Two or More Races (Not Hispanic or Latino) - All persons who identify with more than one of the above five races.
VETERANS DATA:
(Check Yes or No for each of the following questions)
Any veteran of the armed services who served on active duty for at least 181 days, any part of which occurred between August 5, 1964, and May 7, 1975, and
was discharged honorably or released sooner because of a service related disability is considered to be a Vietnam Era Veteran.
Do you qualify as a Vietnam Era Veteran?
[ ] Yes [ ] No
Any person entitled to compensation by the Veterans Administration for a disability rated at 30 percent or more, or who was discharged or released from
active duty by reason of service connected disability is considered a disabled veteran by the U.S. Veterans Administration.
Are you a qualified disabled veteran?
[ ] Yes [ ] No
Other eligible veterans includes two veterans groups. First, those who served in a “War”. Since World War II was the last declared war veterans with active
duty service between December 7, 1941 and April 28, 1952 are considered World War II veterans and are included in the other eligible veterans category.
The second group of other eligible veterans includes those veterans who were awarded the Armed Forces Expeditionary Medal and/or who served in a
campaign or on an expedition for which a campaign badge, a service medal, or an expeditionary medal has been awarded. These military engagements are
listed on the following pages. Please mark which engagement(s), qualify you for inclusion in the other eligible veterans category.
Do you qualify as an other eligible veteran?
[ ] Yes [ ] No
Newly separated veterans include “any veteran during the one year period beginning on the date of such veteran’s discharge or release from active duty”.
Therefore, you are considered newly separated if it has been one-year or less since you left active duty.
Do you qualify as an newly separated veteran?
[ ] Yes [ ] No
DISABILITY DATA:
Any person who has a physical or mental impairment which substantially limits one or more major life activities may be considered an individual with a
disability under our affirmative action plan. If you are an individual with a disability, we would like to include you under our affirmative action compliance
program.
Do you wish to be considered as mentally or physically disabled under our affirmative action plan?
Date:
[ ] Yes [ ] No
Signature of Applicant:
SFBR Form 39 (rev. March 2010)
Campaigns and Expeditions
Campaign or Expedition
Inclusive dates
Armed Forces Expeditionary Medal (AFEM) A veteran's
DD Form 214 showing the award of any Armed Forces
Expeditionary Medal is acceptable proof. The DD form 214
does not have to show the name of the theater or country of
service for which that medal was awarded.
Afghanistan (Operations Enduring Freedom (OEF) and Iraqi
OEF September 11, 2001 to present; OIF March 19, 2003 to present
Freedom (OIF))
Berlin
August 14, 1961 to June 1, 1963
Bosnia
(Operations Joint Endeavor, Joint Guard, and Joint Forge) )
November 20, 1995 to December 20, 1996; December 20, 1996 to June
20, 1998; June 21, 1998 to present
Cambodia
March 29, 1973 to August 15, 1973
Cambodia Evacuation
(Operation Eagle Pull)
April 11 - 13, 1975
Congo
July 14, 1960 to September 1, 1962;
November 23 - 27, 1964
Cuba
October 24, 1962 to June 1, 1963
Dominican Republic
April 28, 1965 to September 21, 1966
El Salvador
January 1, 1981 to February 1, 1992
Global War on Terrorism
September 11, 2001 to present
Grenada
(Operation Urgent Fury)
October 23, 1983 to November 21, 1983
Haiti
Operation Uphold Democracy)
September 16, 1994 to March 31, 1995
Iraq
(Operations Northern Watch, Desert Spring, Enduring
Freedom (OEF), and Iraqi Freedom (OIF))
January 1, 1997 to present;
December 31, 1998 to December 31, 2002 (projected);
OEF September 11, 2001 to present; OIF March 19, 2003 to present
Korea
October 1, 1966 to June 30, 1974
Kosovo
March 24, 1999 to present
Laos
April 19, 1961 to October 7, 1962
Lebanon
July 1, 1958 to November 1, 1958
and June 1, 1983 to December 1, 1987
Mayaguez Operation
May 15, 1975 to May 15, 1975
Operations in the Libyan Area
(Operation Eldorado Canyon)
April 12, 1986 to April 17, 1986
Panama
(Operation Just Cause)
December 20, 1989 to January 31, 1990
Persian Gulf Operation
(Operation Earnest Will)
July 24, 1987 to August 1, 1990
Persian Gulf Operation
(Operation Southern Watch)
December 1, 1995 to present
Persian Gulf Operation
(Operation Vigilant Sentinel)
December 1, 1995 to February 1, 1997
SFBR Form 39 (rev. March 2010)
Persian Gulf Operation
(Operation Desert Thunder)
November 11, 1998 to December 22, 1998
Persian Gulf Operation
(Operation Desert Fox)
December 16, 1998 to December 22, 1998
Persian Gulf Intercept Operation
December 1, 1995 to present
Quemoy and Matsu Islands
August 23, 1958 to June 1, 1963
Somalia
(Operations Restore Hope and United Shield)
December 5, 1992 to March 31, 1995
Taiwan Straits
August 23, 1958 to January 1, 1959
Thailand
May 16, 1962 to August 10, 1962
Vietnam Evacuation
(Operation Frequent Wind)
April 29, 1975 to April 30, 1975
Vietnam (including Thailand)
July 1, 1958 to July 3, 1965
Note: Section 572 of Subtitle G of the Defense Authorization Act of Fiscal Year 1998 (Public Law 105-85), signed into law on
November 18, 1997, allows the Secretary of the military department concerned to determine whether individual members who
participated in Operation Joint Endeavor or Operation Joint Guard in the Republic of Bosnia and Herzegovina and in such other areas
in the region as the Secretary of Defense considers appropriate, meet the individual service requirements for award of the Armed
Forces Expeditionary Medal (AFEM). Generally, service members will be considered eligible if they:



deployed to Bosnia and Herzegovina (or other area that the Secretary of Defense considers appropriate) in direct support of
one or both of the operations;
served on board a ship in the Adriatic in direct support of one or both of the operations; or
operated in airspace above Bosnia, Herzegovina (or other area that the Secretary of Defense considers appropriate) while the
operations were in effect.
Navy expeditionary Medal and Marine Corps Medal for these Operations:
Campaign or Expedition
Inclusive dates
Cuba
January 3, 1961 to October 23, 1962
Indian Ocean/Iran
November 21, 1979 to October 20, 1981
Iranian/Yemen/Indian Ocean
December 8, 1978 to June 6, 1979
Lebanon
August 20, 1982 to May 31, 1983
Liberia
(Operation Sharp Edge)
August 5, 1990 to February 21, 1991
Libyan Area
January 20, 1986 to June 27, 1986
Panama
April 1, 1980 to December 19, 1986 and
February 1, 1990 to June 13, 1990
Persian Gulf
February 1, 1987 to July 23, 1987
Rwanda
(Operation Distant runner)
April 7 - 18, 1994
Thailand
May 16 - August 10, 1962
SFBR Form 39 (rev. March 2010)
Other Campaign and Service Medals Qualifying for Preference:
Campaign or Expedition
Inclusive dates
Army Occupation of Austria
May 9, 1945 to July 27, 1955
Army Occupation of Berlin
May 9, 1945 to October 2, 1990
Army Occupation of Germany
(exclusive of Berlin)
May 9, 1945 to May 5, 1955
Army Occupation of Japan
September 3, 1945 to April 27, 1952
Chinese Service Medal (Extended)
September 2, 1945 to April 1, 1957
Korea Defense Service Medal
July 28, 1954 to (date to be determined)
Korean Service
June 27, 1950 to July 27, 1954
Kosovo Campaign Medal (KCM)
Operation Allied Force
March 24, 1999 to June 10, 1999
Kosovo Campaign Medal (KCM)
Operation Joint Guardian
June 11, 1999 to (date to be determined)
Kosovo Campaign Medal (KCM)
Operation Allied Harbor
April 4, 1999 to September 1, 1999
Kosovo Campaign Medal (KCM)
Operation Sustain Hope/Shining Hope
April 4, 1999 to July 10, 1999
Kosovo Campaign Medal (KCM)
Operation Noble Anvil
March 24, 1999 to July 20, 1999
Kosovo Campaign Medal (KCM)
Task Force Hawk
April 5, 1999 to June 24, 1999
Kosovo Campaign Medal (KCM)
Task Force Saber
March 31, 1999 to July 8, 1999
Kosovo Campaign Medal (KCM)
Task Force Falcon
June 11, 1999 to (date to be determined)
Kosovo Campaign Medal (KCM)
Task Force Hunter
April 1, 1999 to November 1, 1999
Navy Occupation of Austria
May 8, 1945 to October 25, 1954
Navy Occupation of Trieste
May 8, 1945 to October 25, 1954
Southwest Asia Service Medal (SWASM)
(Operations Desert Shield and Desert Storm)
August 2, 1990 to November 30, 1995
Units of the Sixth Fleet (Navy)
May 9, 1945 to October 25, 1955
Vietnam Service Medal (VSM)
July 4, 1965 to March 28, 1973
Rwanda
(Operation Distant Runner)
April 7 - 18, 1994
Thailand
May 16 - August 10, 1962
SFBR Form 39 (rev. March 2010)