"*" indicates required fields Application for Employment Part 1Position Applying For*Date* MM slash DD slash YYYY Are you POST Certifiable? Yes No Referral Source:AdvertisementEmployeeWalk-inPrivate Employment AgencyRelativeOtherFirst Name*Middle NameLast Name*PhoneEmail Address* Street Address City State / Province / Region ZIP / Postal Code Your driver's license number (if driving is an essential job function):Application for Employment Part 2Best time to call you at home:*May we contact you at work?* Yes No If you are under 18 and it is required, can you furnish a work permit?* Yes No If no, please explain:Have you submitted an application here before?* Yes No Have you ever been employed here before?* Yes No Are you legally eligible for employment in this country?* Yes No Type of employment desired:* Full-Time Part-Time Temporary Seasonal Will you relocate if the job requires it?* Yes No Will you travel if the job requires it?* Yes No Are you able to meet the attendance requirements of this position?* Yes No Will you work overtime if required?* Yes No If no, please explain:Have you ever been bonded?* Yes No Have you ever been convicted of a crime in the last seven (7) years?* Yes No Work History (upload resume here)*Max. file size: 50 MB.Application for Employment – Educational BackgroundPlease list the last three schools attended, starting with the most recent.1) School*1) Number of Years Completed*1) Degree/Diploma*1) Major & Minor*2) School2) Number of Years Completed2) Degree/Diploma2) Major & Minor3) School3) Number of Years Completed3) Degree/Diploma3) Major & MinorReferencesList name and telephone number of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.1) Name1) Telephone Number1) Years Known2) Name2) Telephone Number2) Years Known3) Name3) Telephone Number3) Years KnownAdditional InformationList professional, trade, business or civic associations and any offices held. Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability or any other similarly protected status.List organizations and offices heldList special accomplishments, publications, awards, etc. Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability or any other similarly protected status.List any additional information you would like us to consider.Application for Employment – SignatureDisclosure I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the employer’s service whenever it is discovered. I give the employer the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability the employer and its representatives for seeking, gathering and using such information and all other persons, corporations or organization for furnishing such information. The employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any application from consideration for employment on a basis prohibited by local, state or federal law. This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no representative of the employer, other than an authorized officer, as the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer. I understand it is this City’s policy not to refuse to hire a qualified individual with a disability because of that person’s need for reasonable accommodation as required by the ADA. I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization.Signature of Applicant*I present and warrant that I have read and fully understand the foregoing and seek employment under these conditionsAttach resume, references, cover letter, and/or certifications here..Max. file size: 50 MB. Δ