Fillable APPLICATION FOR EMPLOYMENT Please answer every question. Date (City of Sanborn)

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APPLICATION FOR EMPLOYMENT Please answer every question. Date (City of Sanborn)

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The APPLICATION FOR EMPLOYMENT Please answer every question. Date (City of Sanborn) form is 4 pages long and contains:

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  • 25 check-boxes
  • 109 other fields

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File type: PDF

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APPLICATION FOR
EMPLOYMENT
Please read before filling out this application for employment
City of Sanborn
does not discriminate in hiring or employment on the basis of race, color, religion, national origin, sex, ancestry,
physical disability, or age. No such question on this application is intended to secure information to be used for such
discrimination. This application will be given every consideration, but its receipt does not imply that the applicant will be
employed.
Date
Please answer every question.
(First) (Middle) (Last) (Home Telephone Number)
A
ddress
(Number) (Street) (Office Telephone Number)
(City) (State) (Zip)
H
ave you ever applied to the City of Sanborn
before?
Yes
No
Have you been employed by City of Sanborn, previously? Yes
No
If yes, explain when and where
Are you legally eligible to work in the United States? Yes No
The immigration reform control act of 1986 requires that all applicants provide evidence of identity and
eligibility to work prior to employment.
Position desired
Work
Preference
Salary Expectations $
A
pplying for: Full-time Part-time Seasonal Only
How were you referred to us?
Date available for work
Available schedule Weekdays Weekends Evenings Nights Over-time
Do you have any geographic requirements? Yes No
If yes, please explain
EDUCATION
Name City State Work or Subject
Check Last
Year Comp.
Did You
Graduate
Degree
High School
1 2 3 4 Yes No
Business School
1 2 3 4 Yes No
College
1 2 3 4 Yes No
Graduate Work
Technical School
List honors received including scholastic and honorary organizations to which you were elected or appointed:
What community, civic activities are you involved in? (Please indicate any offices held):
Second most recent Employer *Most
R
ecent Employer
While attending college or vocational school, how many hours per week, on the average, were you employed during the
school year?
OTHER QUALIFICATIONS
Please list skills/qualifications you have related to the position you are applying. (Ex: typing wpm.,
shorthand/speedwriting wpm., computer and software skills, applicator’s license, CDL license, etc.)
POSITIONS OF LEADERSHIP HELD:
SUPERVISORY EXPERIENCE
Have you ever supervised people? Yes No
Describe your experience as a supervisor
Do you feel you have good communication skills? Yes No
Explain:
OTHER TRAINING & EXPERIENCE
Describe any training, experiences or qualifications (none previously covered), honors, awards received that might be of
interest to the City of Sanborn:
WORK EXPERIENCE START DATE
Company Name
Address
City
Supervisor’s Name
Reason for Leaving
State
END DATE
Job Title
Telephone
Zip
Starting Salary $
Ending/Current Salary $
May we contact this employer? Yes, immediately Yes, at a later date No, do not contact
Describe your work:
Third most recent Employer
WORK EXPERIENCE START DATE END DATE
Company Name Job Title
Address Telephone
City
State
Zip
Supervisor’s Name
Reason for Leaving
Starting Salary $
Ending/Current Salary $
May we contact this employer? Yes, immediately Yes, at a later date No, do not contact
Describe your work:
PERSONAL REFERENCES
Give three personal references, two who are not related to you and are not former employers and one former employer.
Include only individuals familiar with your work ability.
NAME ADD
R
ESS BUSINESS YEA
R
S AC
Q
UAINTED
JOB RELATED SKILLS
(Do not fill out any part of this section you believe to be non-job related).
If the job requires, do you have the appropriate valid driver’s license? Yes No
DL#
Type
State of Issue
Have you had any moving violations? Yes No Please describe
Do you understand the requirements for this job? Yes No
Is so, please explain
READ BEFORE SIGNING. If you have any questions regarding the following statements, please ask an employment
interviewer for an explanation before signing.
In the event of my employment to a position with the City of Sanborn, I will comply with the rules and regulations as set forth in
the policy manual and other communications distributed to all employees. All individuals who are hired by the City of Sanborn
must provide proof of United States citizenship or eligibility for employment.
I certify that all statements made by me on this application are true and complete to the best of my knowledge and that I have
withheld nothing that would, if disclosed, affect this application unfavorably. Any falsification of the information could be
cause for immediate dismissal if I am hired by the company.
“AT WILL” STATEMENT
I hereby acknowledge that any employment relationship with this company is of an “at will” nature, which means that the
employee may resign at any time, and the employer may terminate employee at any time, with or without cause. No City
of Sanborn
representative is authorized to modify this policy for any employee or to enter into any agreement, oral or written,
contrary to this policy.
NOTICE
I hereby authorize my former employers, educational institutions, and references to furnish any information concerning my
application for employment. I authorize the City of Sanborn
to contact my former employers, educational institutions, and
references for the purpose of obtaining such information. I also understand and agree that I may be required to take post-offer
pre-employment physical examination and drug & alcohol test(s) as a condition of hiring or continued employment. I agree to
consent to take such test(s) at such time as designated by the Company to release the Company, its directors, officers, agents, or
employees from any claim arising in connection with the use of such test(s).
I certify that all the information submitted by me on this application is true and complete and I understand that if any false
information, omissions, or misrepresentations are discovered, by application may be rejected an, if I am employed, my
employment may be terminated at any time.
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APPLICATION FOR EMPLOYMENT Please answer every question. Date (City of Sanborn)

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Completed 16 July 2020

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