Fill - Free fillable 4-application (City of Harker Heights) PDF form

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

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:

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click to sign

signature

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