Fillable APPLICATION FOR EMPLOYMENT - 2014 REVISED - WRITEABLE

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APPLICATION FOR EMPLOYMENT - 2014 REVISED - WRITEABLE

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  • 26 check-boxes
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Country of origin: US
File type: PDF

U.S.A. forms for City of Dahlonega

BROWSE CITY OF DAHLONEGA (GA) FORMS

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APPLICATION FOR EMPLOYMENT
DATE:_____________________
PERSONAL INFORMATION:
NAME:__________________________________________________________________________________________________________________
LAST FIRST MIDDLE
PRESENT ADDRESS:________________________________________________________________________________________________________
STREET CITY STATE ZIP
PHONE NUMBER 1:________________________________________PHONE NUMBER 2:________________________________________________
EMAIL ADDRESS:__________________________________________________________________________________________________________
ARE YOU EIGHTEEN (18) YEARS OF AGE OR OLDER: YES NO
ARE YOU EITHER A U.S. CITIZEN OR AN ALIEN AUTHORIZED TO WORK IN THE UNITED STATES: YES NO
HAVE YOU EVER BEEN CONVICTED OF A CRIME, OR PLED GUILTY OR NOLO CONTENDERE TO ANY CRIME? YES NO
IF YES, PLEASE COMPLETE:
CONVICTION TYPE: FELONY MISDEMEANOR
OFFENSE:________________________________________________________________________________________________________
DATE:___________________________________________________________________________________________________________
LOCATION:_______________________________________________________________________________________________________
(THIS IS NOT A DISQUALIFIER FROM EMPLOYMENT BUT CAN BE USED TO THE EXTENT RELEVANT TO THE JOB BEING PURSUED.)
DO YOU HAVE A VALID DRIVERS LICENSE: YES NO
LICENSE NUMBER:________________________________________________STATE____________________________________________________
CLASS LICENSE:___________________________________________________EXPIRATION DATE:_________________________________________
HAS YOUR LICENSE EVER BEEN SUSPENDED OR REVOKED: YES NO
HAVE YOU EVER BEEN CONVICTED, PLED GUILTY OR NOLO CONTENDERE TO A CHARGE OF DWI OR DUI: YES NO
IF YES, PLEASE EXPLAIN:____________________________________________________________________________________________________
ARE THERE ANY DWI OR DUI CHARGES CURRENTLY PENDING AGAINST YOU? YES NO
IF YES, PLEASE EXPLAIN:____________________________________________________________________________________________________
EMPLOYMENT DESIRED:
POSITION:_____________________________________________________________________________SALARY DESIRED:____________________
ARE YOU CURRENTLY EMPLOYED: YES NO
IF YES, MAY WE INQUIRE OF YOUR CURRENT EMPLOYER? YES NO
REFERRED BY:____________________________________________________________________________________________________________
EDUCATION HISTORY:
HAVE YOU RECEIVED A GED OR HIGH SCHOOL DIPLOMA: YES NO
HIGH SCHOOL ATTENDED:__________________________________________________________________________________________________
COLLEGE ATTENDED:_______________________________________________________________________________________________________
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL ATTENDED:_____________________________________________________________________
I ACKNOWLEDGE, SHOULD I RECEIVE A JOB OFFER, I WILL BE REQUIRED TO SUBMIT PROOF OF EDUCATION HISTORY (IF REQUIRED BY THE JOB)
_____________________
INITITALS
EMPLOYMENT HISTORY:
PLEASE DESCRIBE YOUR WORK HISTORY FOR THE LAST FIVE (5) YEARS INCLUDING MILITARY IF APPLICABLE. LIST THE NAMES OF YOUR PRESENT
OR PREVIOUS EMPLOYERS IN CHRONOLOGICAL ORDER WITH PRESENT OR MOST CURRENT EMPLOYER LISTED FIRST. FAILURE TO PROVIDE
COMPLETE INFORMATION REGARDING EACH JOB HELD MAY RESULT IN YOUR DISQUALIFICATION. A RESUME MAY BE ATTACHED ONLY AS
ADDITIONAL INFORMATION AND WILL NOT BE ACCEPTED IN LIEU OF COMPLETING THIS SECTION.
DATE NAME OF EMPLOYER SALARY POSITION
FROM:______________________ ____________________________________ ________________________ ________________________
TO:_________________________ ____________________________________ ________________________ ________________________
FROM:______________________ ____________________________________ ________________________ ________________________
TO:_________________________ ____________________________________ ________________________ ________________________
FROM:______________________ ____________________________________ ________________________ ________________________
TO:_________________________ ____________________________________ ________________________ ________________________
FROM:______________________ ____________________________________ ________________________ ________________________
TO:_________________________ ____________________________________ ________________________ ________________________
FROM:______________________ ____________________________________ ________________________ ________________________
TO:_________________________ ____________________________________ ________________________ ________________________
PLEASE EXPLAIN ANY GAPS IN YOUR EMPLOYMENT HISTORY. BE SURE TO ACCOUNT FOR ALL PERIODS OF TIME INCLUDING MILITARY SERVICE
AND ANY PERIODS OF UNEMPLOYMENT.
HAVE YOU EVER BEEN TERMINATED OR ASKED TO RESIGN FROM ANY JOB: YES NO
IF YES, PLEASE EXPLAIN THE CIRCUMSTANCES:__________________________________________________________________________________
________________________________________________________________________________________________________________________
LIST ANY PROFESSIONAL DESIGNATIONS, CERTIFICATIONS, COURSES, OR SPECIAL SKILLS THAT MAY BE APPLICABLE TO THE JOB FOR WHICH YOU
ARE APPLYING:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
PLEASE DESCRIBE ANY OTHER EXPERIENCE (TO INCLUDE MILITARY) THAT YOU HAVE WHICH WOULD BE RELEVANT TO THE JOB FOR WHICH YOU
ARE APPLYING:
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
REFERENCES:
NAME ADDRESS PHONE
1.__________________________________ ________________________________________________ ______________________________
2.__________________________________ ________________________________________________ _____________________________
3.__________________________________ ________________________________________________ _____________________________
I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND
THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.
I AUTHORIZE PRESENT AND PREVIOUS EMPLOYERS AND REFERENCES LISTED ON APPLICATION TO PROVIDE THE CITY ANY PERTINENT
INFORMATION.
I AUTHORIZE THE CITY TO PROVIDE FUTURE EMPLOYERS ANY PERTINENT INFORMATION CONCERNING THE EMPLOYMENT WITH THE CITY, IF
HIRED.
I AUTHORIZE A PRE-EMPLOYMENT PHYSICAL AND DRUG SCREEN.
I AUTHORIZE AN EXTENSIVE BACKGROUND CHECK WHICH MAY INCLUDE CONTACTING PAST EMPLOYERS, SCHOOLS ATTENDED, CRIMINAL
HISTORY, MOTOR VEHICLE RECORD AND CREDIT CHECK.
I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT
OF MY WAGES AND SALARY, BE TERMINATED AT ANY TIME WITHOUT PRIOR NOTICE AND WITHOUT CAUSE.
DATE:___________________________SIGNATURE:______________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
DO NOT WRITE BELOW THIS LINE
INTERVIEWED BY:___________________________________________________________________________DATE:_________________________
REMARKS:_______________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
HIRED: YES NO POSITION:____________________________________DEPARTMENT:____________________________
SALARY/WAGE:________________________________________________BEGINNING DATE:____________________________________________
APPROVED:____________________________________________________ ________________________________________________________
CITY MANAGER DEPARTMENT HEAD/SUPERVISOR
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APPLICATION FOR EMPLOYMENT - 2014 REVISED - WRITEABLE

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Completed 12 July 2020

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