Fillable 91

Fill Online, Printable, Fillable, Blank 91 Form

Use Fill to complete blank online OTHERS (US) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

91

On average this form takes 30 minutes to complete

The 91 form is 6 pages long and contains:

  • 3 signatures
  • 15 check-boxes
  • 101 other fields

Country of origin: US
File type: PDF

BROWSE OTHERS (US) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1
Employment Application – 8/1/15
City of Aransas Pass
600 Cleveland Blvd.
Aransas Pass, Texas 78336
(361)
7
58-5301
Employment Application
The City of Aransas Pass considers 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.
PLEASE FOLLOW THESE INSTRUCTIONS TO COMPLETE THE APPLICATION
1. The City will only consider applications that are complete. You must provide all requested
information, including your signature.
2. You may submit a resume in addition to your application. However, resumes will not take the
place of the application.
3. Your application will be reviewed after the posted deadline, as noted on the employment
opportunity notice.
4. The City of Aransas Pass will contact (either by telephone or e-mail) the applicants selected for
pre-placement testing and/or personal interview.
5. A new application must be submitted for every position you wish to be considered for.
PLEASE PRINT
Position Applying For:
Date of Application:
Last Name:
First Name:
Mailing Address: City: State: Zip Code:
Primary Phone Number: Secondary Phone Number:
Driver’s License/I.D. Number: State: License Type: Class C Class B-CDL
Class A-CDL Other
2
Employment Application – 8/1/15
Please answer the following questions listed below:
1. Are you related by blood, marriage or common law to the City Manager, any City Council member or any
other City employee? Yes No
If yes, list names and relationship type: ________________________________________________
2. If you are under the age of 18, can you provide required proof of your eligibility to work?
Yes No
3. Have you previously been employed by the City of Aransas Pass? If so, please provide date(s).
Yes No If yes, list dates of employment: _______________________________________
4. Are you currently on “lay off” status and subject to recall with the City of Aransas Pass?
Yes No
5. Have you ever been convicted of a felony, public indecency or a violation of the Texas controlled
substances act, or have you ever pled guilty or no contest to a criminal act, or have you been placed on
probation or had your driver’s license suspended or revoked, or been notified of any exclusion or
sanctioning by a federal program? Yes No
Note: A positive response to any part of the question will not necessarily bar you from being considered for
employment. The City of Aransas Pass will consider the offense for which you were convicted, the circumstances
surrounding the conviction and the date of the conviction as important factors in making a hiring decision.
If your answer to any of the above is “Yes”, please provide details, including dates below:
______________________________________________________________________________________
______________________________________________________________________________________
Education
Do you have a High School diploma/GED?
Yes No If yes, name of school/institution: _________________________________________
Please specify your highest level of education:
High School diploma/GED
Some College
Associate’s Degree Please identify course work: _________________________________
Bachelor’s Degree Please identify course work: _________________________________
Some Graduate Please identify course work: _________________________________
Graduate Degree Please identify course work: _________________________________
Other Please identify course work: _________________________________
3
Employment Application – 8/1/15
Licenses and / or Certifications:
License/Certification Number
Expiration Date
List any specialized training, skills, proficiency in any foreign language, etc. You may also include
professional, trade, business or civic activities and offices held:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Employment History: Please list your last ten (10) years of employment beginning with your most recent
job. Include any job-related military service assignments and volunteer activities.
Name of Employer: Dates of Employment:
Address of Employer: Phone Number:
Job Title: Final Rate of Pay:
Name of Supervisor:
Job Duties:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Reason for Leaving:
Name of Employer: Dates of Employment:
Address of Employer: Phone Number:
Job Title: Final Rate of Pay:
Name of Supervisor:
Job Duties:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Reason for Leaving:
4
Employment Application – 8/1/15
Name of Employer: Dates of Employment:
Address of Employer: Phone Number:
Job Title: Final Rate of Pay:
Name of Supervisor:
Job Duties:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Reason for Leaving:
Name of Employer: Dates of Employment:
Address of Employer: Phone Number:
Job Title: Final Rate of Pay:
Name of Supervisor:
Job Duties:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Reason for Leaving:
Name of Employer: Dates of Employment:
Address of Employer: Phone Number:
Job Title: Final Rate of Pay:
Name of Supervisor:
Job Duties:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Reason for Leaving:
5
Employment Application – 8/1/15
Please state any information you feel may be beneficial to our consideration of your application.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Military Service Record
Did you ever serve in the United States Armed Forces? Yes No
If so, please indicate the branch: ___________________ Dates of Duty: ___________ to ___________
Month/Year Month/Year
Did you receive an Honorable Discharge? Yes No
List duties in the service including any special training:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
If the position you are applying for requires proof of an honorable discharge, please attach a copy of your DD214.
Applicant Statement:
I certify that the answers given are true and complete to the best of my knowledge. I hereby certify that there are
no willful misrepresentations, omissions or falsifications in the foregoing statements and answers to questions. I
authorize investigation of all statements contained in this application for employment as may be necessary in
arriving at an employment decision.
This application for employment shall be considered active for a period of time not to exceed 45 days. Any
applicant wishing to be considered for employment beyond this time period should inquire as to whether or not
applications are being accepted at that time.
I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment
relationship with this organization is an “at will” nature. This means that the employee may resign at any time and
that the employer may discharge the employee at any time with or without cause. It is further understood that
this “at will” employment relationship may not be changed by any written document or by conduct unless an
authorized executive or this organization specifically acknowledges such change in writing.
In the event of employment, I am fully aware that my misrepresentations, omissions, or falsifications given in my
application or interview(s) will be grounds for immediate rejection of my application, or if hired, termination of
my employment. I understand, also, that I am required to abide by all rules and regulations of the employer.
________________________________ ________________________________ _____________
Signature Print Name Date
click to sign
signature
click to edit
6
Employment Application – 8/1/15
Authorization to Release Information
(Private Person or Organization) To The City of Aransas Pass
To Whom It May Concern:
I am an applicant for employment with the City of Aransas Pass, Texas, and hereby request and authorize you to
furnish the City of Aransas Pass with any and all information they may request concerning my employment,
educational records, including by not limited to academic, achievement, attendance, athletic, personal history and
disciplinary records, medical records, credit records, juvenile, police and court records or military records for
determination of my potential for employment and for eligibility for certain security clearance. I hereby direct you
to release such information upon request of the bearer. This release is executed with full knowledge and
understanding that the information is for the official use of the aforementioned City of Aransas Pass.
I hereby release you, as custodian of such records, any school, college, university, or other educational
institution, hospital or other repository of medical records, credit bureau, lending institution, consumer or credit
reporting agency, or retail business establishment including its officers, employers, or related personnel, both
individually or collectively, from any and all liability or damages of whatever kind which at any time may result to
me, my heirs, family or associates because of compliance with this authorization and request for information or
any other attempt to comply with it.
________________________________ ________________________________ _____________
Signature Print Name Date
Authorization to Conduct Investigation
The facts set forth in my application for employment are true and complete. I understand that if employed, any
false or misleading statements on this application shall be considered sufficient cause for dismissal. I hereby
authorize the City of Aransas Pass to make any investigation concerning my employment; educational records,
including by not limited to academic, achievement, attendance, athletic, personal history and disciplinary records,
medical records, credit records, juvenile, police and court records or military records for determination or my
potential for employment and for eligibility for certain security clearances. I also understand that an investigative
consumer report may be made whereby information is obtained through personal interviews with my neighbors,
friends or others with whom I am acquainted. This inquiry, if made, may include information as to my character,
general reputation, personal characteristics and mode of living. I understand that I have the right to make a
written request within a reasonable period of time to receive additional, detailed information about the nature
and scope of any such investigative report that is made.
________________________________ ________________________________ _____________
Signature Print Name Date
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

91

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 10 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document