Fillable APPLICATION FOR EMPLOYMENT (PLEASE PRINT) (Spencer County)

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APPLICATION FOR EMPLOYMENT (PLEASE PRINT) (Spencer County)

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U.S.A. forms for Spencer County

BROWSE SPENCER COUNTY (KY) FORMS

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APPLICATION FOR EMPLOYMENT

NAME:__________________________POSITION:___________________________DATE:___________

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.

(PLEASE PRINT)

Position(s) Applied For Date of Application

How Did You Learn About Us?

Employment Agency

Friend

Relative

Walk-In

Other _______________________________

Last Name First Name Middle Name

Address: Number Street City 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? If Yes, give date ____________________

Have you ever been employed with us before?

If Yes, give date ____________________

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

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

Have you been convicted of a felony ?

Conviction will not necessarily disqualify an applicant from employment

If Yes, please explain

________________________________________________________________________

Yes No

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

Education

Name and

Address of

School

Course of Study Years

Completed

Diploma

Degree

Elementary

School

High

School

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.

Describe any job-related training received in the United States military.

Employment Experience

Start with your present or last job. Include any job-related military service assignments and

volunteer activities. You may exclude organizations which indicate race, color, religion, gender,

national origin, disabilities or other protected status.

1. Employer Dates Employed

Work Performed

From To

Address

Telephone Number(s) Hourly Rate/Salary

Starting Final

Job Title Supervisor

Reason for Leaving

2. Employer Dates Employed

Work Performed

From To

Address

Telephone Number(s) Hourly Rate/Salary

Starting Final

Job Title Supervisor

Reason for Leaving

3. Employer Dates Employed

Work Performed

From To

Address

Telephone Number(s) Hourly Rate./Salary

Starting Final

Job Title Supervisor

Reason for Leaving

4. Employer Dates Employed

Work Performed

From From

Address

Telephone Number(s) Hourly Rate/Salary

Work Performed

Starting Final

Job Title Supervisor

Reason for Leaving

If you need additional space, please continue on a separate sheet of paper.

List professional, trade, business or civic activities and offices held.

You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status:

Additional Information

Other Qualifications

Summarize special job-related skills and qualifications acquired from employment or other experience.

Specialized Skills Check Skills/Equipment Operated

Production/Mobile

Machinery (list): Other (list):

_____________ ______________

___

FiscalBooks

___PC

___

____

Adobe Suite

____Word Press

____Word Suite

_____________ ______________

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)

Applicants’ Statement

I certify that answers given herein are true and complete to the best of my knowledge.

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 of an “at will” nature, which means that the

Employee may resign at any time and the Employer may discharge 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 such change is specifically acknowledged in writing by an

authorized executive of this organization.

I understand this application and any attached documentation become part of the Spencer County Fiscal

Court records and will not be returned to me once submitted. I am also aware that my application is

subject to the Kentucky Open Records Laws and may be released as a public document.

In the even t of employment, I understand that false or misleading information given in

my application of interview(s) may result in discharge. I understand, also, that I am required to

abide by all rules and regulations of the employer.

_____________________________________ ________________________

Signature of Applicant Date

FOR PERSONNEL DEPARTMENT USE ONLY

Arrange Interview Yes No

Remarks ______________________________________________________________________________________________

____________________________________________________ _______________________________________

INTERVIEWER DATE

Employed YES NO Date of Employment _________________________________________

Hourly/Rate

Job Title ___________________________ Salary ___________________ Department ___________________________________

By_____________________________________________________________________________________

Fillable APPLICATION FOR EMPLOYMENT (PLEASE PRINT) (Spencer County)

Fill Online, Printable, Fillable, Blank APPLICATION FOR EMPLOYMENT (PLEASE PRINT) (Spencer County) Form

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