Form P-15
APPLICATION
FOR EMPLOYMENT
Revised October 30, 2019
P
E
R
S
O
N
A
L
Last Name First Middle
Date
Street Address
Home Telephone
( )
City, State, Zip
Business Telephone
( )
Have you ever applied for employment with us?
Yes No If yes: Month and Year Location
Social Security #
Position Desired Texas Drivers License #
Are you available for full-time work?
Yes No If not, what hours can you work?
Desired Pay
Are you legally eligible for employment in the United States? Yes No
(Proof of citizenship or immigration will be required upon employment)
When will you be available to
begin wo
rk?
If employed and you are under 18, can you furnish a work permit? Yes
No Will you work overtime if asked?
Yes No
Other special training or skills (electrical, mechanical , clerical or technical, etc.)
Can you work weekends when
scheduled or re
quested?
Yes No
Have you ever been convicted, plead guilty or no contest, or received deferred adjudication before: Yes No
If yes, give date and detail of each conviction. (A conviction record is not an automatic ban to employment. The nature of the crime will be
considered in relation to the position for which you are applying)
Li
st any prev
i
ous or current re
l
at
i
ves t
h
at you may
h
ave t
h
at wor
k
f
or t
h
e
Ci
ty o
f
H
ar
k
er
H
e
i
g
h
ts.
MILITARY
Did you serve in th
e
Yes No
U.S. Armed Forces?
If Yes, what branch
Type discharge received
(a less than honorable discharge is not an automatic ban to employment. The circumstances of
the discharge will be considered in relation to the position for which you are applying)
Describe any training received relevant to the position for which you are applying.
Prospective employees will receive consideration without discrimination
because of race, creed, color, sex, age, national origin, disability, or veteran status.
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Please tell us how you heard about this position.
2
How long have you lived at present address?
(Years) (Months)
Please list previous address
E
D
U
C
A
T
I
O
N
School
Name and Location of School
Course of Study
No. Of
Years
Completed
Did You
Graduate?
Degree or
Diploma
Graduate
Yes
No
College
Yes
No
Business/Trade/
Technical
Yes
No
High School
Yes
No
EMPLOYMENT
Please give accurate, complete full-time and part-time
employment record. Start with your present or most
recent employer.
1
Company Name and Address
Supervisor
Telephone
( )
Employed - (month and year)
From To
State Job Title and Describe Your Work Weekly pay
Start Last
Reason for Leaving
2
Company Name and Address
Supervisor
Telephone
( )
Employed - (month and year)
From To
State Job Title and Describe Your Work Weekly pay
Start Last
Reason for Leaving
3
3
Company Name and Address
Super
visor
T
elephone
( )
Employed - (month and year)
Fro
m
To
State Job Title and Describe Your Work Weekly pay
Start Last
Reason for Leaving
4
Company Name and Address
Super
visor
T
elephone
( )
Employed - (month and year)
From To
State Job Title and Describe Your Work Weekly pay
Start Last
Reason for Leaving
We may contact the employers listed
above unless you indicate those you do
not want us to contact.
DO NOT CONTACT
Employer Number(s)
Reason
Please pr
ovide any information you feel we should know when we contact your previous employers
Comments regarding lapses in employment, if applicable
Have y
ou ever been discharged from a job or forced, or asked to resign?
Yes No If yes, provide explanation
Machinery and equipment you can operate?
If applying for an office position: Typing: approximate WPM
Shorthand: approximate WPM
Business machines you can operate:
Com
puter experience (list software):
4
G
O
A
L
S
W
hat are your long range occupational goals?
R
E
F
E
R
E
N
C
E
S
List the name and current phone number of four individuals (not
relatives or former employers), who can provide a personal reference:
Nam
e and address
Phone number
1.
2.
3.
4.
S
I
G
N
A
T
U
R
E
I certify that all the inform
ation provided in this application for employment is true, complete and correct.
I understand and agree that the om
ission or misrepresentation of any fact in the application for employment will be
sufficient reason for the City of Harker Heights to deny me employment. I also understand and agree that should I
become employed by the City of Harker Heights and it is later discovered I have omitted or misrepresented any fact in
this application, the City of Harker Heights may immediately terminate my employment upon discovery of such
omission or misrepresentation. I understand and agree that should I fail my background/criminal investigation, this
will be grounds for disqualification or immediate termination.
Applicant
Signature:
Date:
Revised2FWREHU
click to sign
signature
click to edit
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