Fillable APPLICATION FOR EMPLOYMENT The City of Norman Human (City of Norman)

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APPLICATION FOR EMPLOYMENT The City of Norman Human (City of Norman)

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FOR OFFICE USE ONLY
APPLICATION FOR EMPLOYMENT
The City of Norman
Human Resources Department
P.O. Box 370 201-C West Gray
Norman, OK 73070 Norman, OK 73069
(405) 366-5482
JOB LINE 366-5321
www.NormanOK.gov/HR/HR-Job-Postings
AN EQUAL OPPORTUNITY EMPLOYER
The City of Norman does not discriminate on the basis of race, color, religion, sex, national origin, age, marital or veteran
status, political affiliation, disability, or any other legally protected status.
This is an application for employment and no employment contract is being offered. After a selection has been made, this
application will not be considered for any other position. If you need assistance in completing this application form or in par-
ticipating in the selection process, please inform a member of the Human Resources staff.
INSTRUCTIONS: Applications which are not complete will not be processed. No faxed applications will be accepted.
PERSONAL
1. Name Date
LAST FIRST MIDDLE
2. Address
STREET ADDRESS CITY STATE ZIP
3. Mailing Address
IF DIFFERENT FROM STREET ADDRESS
4. E-Mail Address
5. Cell No. Home No. Msg/Work No.
6. Are you eighteen years of age or older? Yes
No
7. Position desired Dept/Division
Rate of expected pay $ per
8. Are you available to work Full-time
Part-time
Specify days and hours if part-time:
9. Were you previously employed by us? Yes No
If yes, when?
10. Are you a U.S. Citizen? Yes No If no, do you have a legal right to work in the U.S.?
Explain:
11. Driver’s License
STATE TYPE/CLASS OF LICENSE EXPIRATION DATE
12. Are you related to any City employee or any member of the City Council? Yes
No
If yes, give name, department, and relationship:
13. Have you been convicted of a felony in the last 7 years or are you currently charged with the commission of a felony?
Yes No If yes, state what, when, and how:
hour
14. What experience, training, or education do you have that would relate to this position?
If you are considered for the job, after the selection process, and you would need reasonable accommodation to perform the
essential job functions, the City of Norman will explore these alternatives. (The City of Norman requires a pre-employment
medical examination for some positions which will determine whether you can do the essential functions of the job without
substantial risk to yourself and the public.)
EDUCATION RECORD
PERSONAL REFERENCES
Give name, occupation, address, and phone number of THREE references who are not related to you and are not current or
previous employers.
TYPE OF SCHOOL
NAME AND ADDRESS
How Many
Years Attended
Graduated
COURSE/MAJOR
HIGH SCHOOL
COLLEGE
GRADUATE SCHOOL
BUSINESS OR TRADE
OTHER
Name Occupation Address Phone Number
EMPLOYMENT HISTORY
List past 10 years of employment, beginning with your most recent/current employer. Account for all gaps in employment.
Supplemental Employment History forms are available upon request.
EMPLOYER: JOB TITLE:
ADDRESS: SUPERVISOR:
CITY/STATE: TELEPHONE:
STARTING DATE: STARTING SALARY:
ENDING DATE: ENDING SALARY:
AVG. # OF HOURS WORKED/WEEK: MAY WE CONTACT EMPLOYER: YES NO
DUTIES RESPONSIBILITIES:
REASON FOR LEAVING:
EMPLOYER: JOB TITLE:
ADDRESS: SUPERVISOR:
CITY/STATE: TELEPHONE:
STARTING DATE: STARTING SALARY:
ENDING DATE: ENDING SALARY:
AVG. # OF HOURS WORKED/WEEK: MAY WE CONTACT EMPLOYER: YES NO
DUTIES RESPONSIBILITIES:
REASON FOR LEAVING:
EMPLOYER: JOB TITLE:
ADDRESS: SUPERVISOR:
CITY/STATE: TELEPHONE:
STARTING DATE: STARTING SALARY:
ENDING DATE: ENDING SALARY:
AVG. # OF HOURS WORKED/WEEK: MAY WE CONTACT EMPLOYER: YES NO
DUTIES RESPONSIBILITIES:
REASON FOR LEAVING:
EMPLOYER: JOB TITLE:
ADDRESS: SUPERVISOR:
CITY/STATE: TELEPHONE:
STARTING DATE: STARTING SALARY:
ENDING DATE: ENDING SALARY:
AVG. # OF HOURS WORKED/WEEK: MAY WE CONTACT EMPLOYER: YES NO
DUTIES RESPONSIBILITIES:
REASON FOR LEAVING:
READ CAREFULLY BEFORE SIGNING
I certify that facts given in this application are true and complete to the best of my knowledge. I hereby grant permission to the City of Norman to investigate
any information included in the application, and I agree to submit to medical examination, if required. The City of Norman requires pre-employment drug
screening and criminal record search for all position. I understand that this application is not a contract of employment. I hereby release the City of Norman
and its agents from all liability in making any investigation or inquiry relative to any information contained in the application form. I understand that, if em-
ployed, false or misleading statements given in this application or interview(s) may result in discharge. If hired, I understand probationary and temporary
employees have no rights to permanent employment and may be terminated without cause at the discretion of the City. I understand that I am required to
abide by all rules and regulations of the City of Norman. This application must be signed (handwritten or electronic) and dated for employment consideration.
SIGNATURE OF APPLICANT DATE
Applicant Name:
FOR TEST ADMINISTRATOR’S USE
TESTS
ADMINISTERED
DATE SCORE RETEST COMMENTS
SPELLING
TYPING
DATA ENTRY
UMPIRE: BASEBALL
UMPIRE: SOFTBALL
MICROSOFT WORD
MICROSOFT EXCEL
MICROSOFT PUBLISHER
MICROSOFT ACCESS
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APPLICATION FOR EMPLOYMENT The City of Norman Human (City of Norman)

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Completed 22 February 2021

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