Fillable 2017 Employment Application Fillable (City of Geneva)

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2017 Employment Application Fillable (City of Geneva)

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BROWSE CITY OF GENEVA (OH) FORMS

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CITY OF GENEVA
Application for Employment
(PLEASE PRINT)
Position(s) Applied For
Date of Application
How Did You Learn About Us?
Advertisement Friend Walk-In
Employment Agency Relative Other ______________________________
Last Name First Name Middle Name
Address Number Street City State Zip Code
Telephone Number(s)
Social Security Number
If you are under 18 years of age, can you provide required
proof of your eligibility to work? Yes No
Have you ever filed an application with us before? Yes No
If Yes, give date _________________
Have you ever been employed with us before? Yes No
Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you prevented from lawfully becoming employed in this
country because of Visa or Immigration Status?
Proof of citizenship or immigration status will be required upon employment. Yes No
If Yes, give date _________________
On what date would you be available for work? _________________
Are you available to work: Full Time Part Time Shift Work Temporary
Are you currently on “lay-off” status and subject to recall? Yes No
Can you travel if a job requires it? Yes No
WE ARE AN EQUAL OPPORTUNITY EMPLOYER
We consider applicants for all positions without regard to race, color, religion, creed, gender,
national origin, age, disability, marital or veteran status, sexual orientation, or any other
legally protected status.
Education
Name and Address
Of School
Course of Study
Years
Completed
Diploma
Degree
Elementary
School
High
School
Undergraduate
College
Graduate
Professional
Other
(Specify)
Indicate any foreign languages you can speak, read and/or write
FLUENT
GOOD
FAIR
SPEAK
READ
WRITE
Describe any specialized training, apprenticeship, skills and Extra-curricular activities.
Employment Experience
Start with your present or last job. Include any job-related military service assignments and
volunteer activities. You may exclude organizations, which include race, color, religion, gender,
national origin, disabilities or other protected status.
Name of employer:
Address:
Name of last
supervisor
Employment
dates
Pay or salary
City, State, Zip Code:
Phone number:
From
To
Start
Final
Your last job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Name of employer:
Address:
Name of last
supervisor
Employment
dates
Pay or salary
City, State, Zip Code:
Phone number:
From
To
Start
Final
Your last job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
Name of employer:
Address:
Name of last
supervisor
Employment
dates
Pay or salary
City, State, Zip Code:
Phone number:
From
To
Start
Final
Your last job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions
while you worked at this company.
If you need additional space, please continue on a separate sheet of paper.
Additional Information
Other Qualifications
Summarize special job-related skills and qualifications acquired from employment or other
experience.
Specialized Skills Check Skills/Equipment Operated
____ Windows
____ Mac/Apple
____ Internet
Production Mobile
Machinery (list):
____ Excel
____ QuickBooks
____ E-mail
________________
____ Microsoft Word
____ Publisher
____ Fax
________________
____ Adobe
____ PowerPoint
____ Typewriter
Other (list)
________________
____ WordPerfect
____ PageMaker
____ Calculator
________________
State any additional information you feel may be helpful to us in considering your application.
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN
INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE
APPLYING.
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the
activities involved in the job or occupation for which you have applied? A description of the activities
involved in such a job or occupation is attached.
___ YES ___ NO
References
1. ___________________________________________________________________( )__________
(Name) (Phone)
(Address)
2. ___________________________________________________________________( )__________
(Name) (Phone)
(Address)
3. ___________________________________________________________________( )__________
(Name) (Phone)
(Address)
4. ___________________________________________________________________( )__________
(Name) (Phone)
(Address)
5. ___________________________________________________________________( )__________
(Name) (Phone)
(Address)
CITY OF GENEVA
APPLICANT RELEASE FORM
I, ________________________, presently reside at _____________________________,
______________________, Ohio has applied for employment with the City of Geneva. I have
been advised and am fully aware that a representative of the City of Geneva will be conducting a
thorough investigation of my background to assist in determining my suitability for this
employment. I realize that, in conducting this background investigation, a city representative
will make inquires of; officials and record officers at schools which I have attended; physicians
and/or other persons who may have examined or tested me for any physical or other type of
illness or injury; police or courts with whom I may have an arrest or conviction record; credit
bureaus and/or firms which may have information regarding my credit record and/or financial
standing; present and previous employers; BMV records and any other persons who may be able
to provide information about me which the City of Geneva desires.
I hereby give my permission and waive all provisions of law forbidding any physician or any
other person who has attended me, or any other school official, court, police agency, credit
bureau, employer, firm, or person, from disclosing any knowledge or information they have
concerning me which is requested or desired by the City of Geneva. I further consent and
request that the public safety director of the City of Geneva or his representative is provide with
a copy of any such record concerning me, which they may desire.
I recognize the right of the City of Geneva to treat, at its discretion, certain sources as
confidential, and its right to withhold from my agent or me the names of such confidential
sources, and information obtained there from.
By: _______________________________
Dated: ____________________________
Witnesses:
_______________________________
_______________________________
Affirmative Action Voluntary Information
Completion of information below is voluntary.
The City of Geneva considers all applicants for positions without regard to race, color, religion, sex, national origin, citizenship, age, mental
or physical disabilities, veteran/reserve/national guard or any similarly protected status. The City of Geneva also complies with all
applicable laws governing employment practices and does not discriminate on the basis of any unlawful criteria.
Applicant can complete this on a voluntary basis. This is not for interview purposes. This form will be filed separate from application.
In an effort to comply with requirements regarding government record keeping, reporting and other legal obligations which may apply, the
City of Geneva invites you to complete this applicant survey. Providing this information is STRICTLY VOLUNTARY. Failure to fill out this
survey will not subject you to any adverse personnel decision or action.
This survey is NOT part of your official application for employment. It will not be used in any hiring decision. The
information will be used and kept confidential in accordance with applicable laws and regulations.
Please Print
Position (s) applying for _________________________________________________________
Referral Source
_____
Walk-In
_____
Government Employment Agency
_____
Relative
_____
Employee
_____
Private Employment Agency
_____
Advertisement - Source
_____
School
Applicant Information
Name
____________________________________________
Telephone
( )
_______________
Last First
Middle
Address
____________________________________________________________________
Street
City
State
Zip Code
Please check the following Equal Employment Opportunity Identification Groups:
_____
American Indian/Alaskan Native
_____
White
_____ Male
_____
Native Hawaiian/Other Pacific Islander
_____
Asian
_____
Hispanic/Latino (White race only)
_____
Black/African American
_____ Female
_____
Hispanic/Latino (all other races)
For Administrative Use Only
Position(s) applied for
_____
Available
_____
Not Available
_____
Other
Other positions considered for
_____________________________________________________
Hired
_____
Yes
_____
No
Position hired for
_____________________________________________________
From the EEO job classifications listed below, which one best describes the position filled?
_____
Officials and Managers
_____
Office and Clerical Workers
_____
Professionals
_____
Craft Workers (Skilled)
_____
Technicians
_____
Operatives (Semi-skilled)
_____
Sales Workers
_____
Laborers (Un-skilled)
_____
Service Workers
Completed By ______________________________________
Date ____/____/____
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2017 Employment Application Fillable (City of Geneva)

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Completed 15 July 2020

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