Fillable Application Complete The Online Application (City of Falls Church)

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Application Complete The Online Application (City of Falls Church)

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  • 31 check-boxes
  • 94 other fields

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U.S.A. forms for City of Falls Church

BROWSE CITY OF FALLS CHURCH (VA) FORMS

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Applicants will receive consideration without discrimination
because of race, creed, color, gender, age, sexual orientation,
national origin or disability.
APPLICATION FOR EMPLOYMENT
Only completed applications will be evaluated.
Job title you are applying for?
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Home Phone
() -
Alternate Phone Number
() -
Business Phone
() -
Social Security Number
If yes, give details on back of application
Have you ever been dismissed from employment, asked or forced to resign to avoid being dismissed?
(If yes, please explain. Extra space on back of application)
Yes ❏ No ❏
Yes ❏ No ❏
Date you are available to begin
work?
Name
Street Address
City, State, Zip
Have you ever applied for employment with the City of Falls Church? Yes ❏ No ❏
Have you ever been employed by the City of Falls Church? Yes ❏ No ❏
If yes, state date and position:
Driver License Number: State:
Have you ever been convicted of a criminal offense (other than minor traffic violations or juvenile offenses) ?
Additional Credit
Courses
(Business,military,
technical, etc.)
Is it currently valid? Yes ❏ No ❏
State relationship: Name Yes ❏ No ❏
SCHOOL NAME AND LOCATION OF SCHOOL COURSE DID YOU DEGREE OR
OF STUDY GRADUATE? CREDITS
RECEIVED
College
Yes ❏
No ❏
Most Recent
High School
Yes
❏
or Junior
High School
Attended
No ❏
Does the City of Falls Church employ any relative of yours (by blood or marriage)?
703-248-5127; FAX 703-531-3385; Email hr@fallschurchva.gov
Mail to: Human Resources Division, City of Falls Church
300 Park Avenue, Falls Church, VA. 22046-3332
In accordance with the Immigration & Reform Control Act of 1986, the City of Falls Church will employ only persons legally
authorized to work in the United States. State whether you are legally eligible to work in the U.S.A. Employment is conditional on
providing proof of eligibility within 3 days of employment.
Yes ❏ No ❏
Y
es ❏
No
❏
Yes ❏
No ❏
Your Job Title Dates of Employment - Give Month and Year
From To
Employer Type of Business
Hourly or Annual Pay:
Start
End
Address Supervisor's Phone Number
( ) -
Name and Title of Immediate Supervisor May we contact your supervisor for
reference? Yes ❏ No ❏
Description of Duties
Reason for seeking other employment?
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P
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Your Job Title Dates of Employment - Give Month and Year
From To
Employer Type of Business
Hourly or Annual Pay:
Start
End
Address Supervisor's Phone Number
( ) -
Name and Title of Immediate Supervisor May we contact your supervisor for
reference? Yes
❏ No ❏
Description of Duties
Reason for seeking other employment?
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IMPORTANT:
Give a complete record of your employment history including part-time work, military service, and internships. Start with your
present or most recent position. Account for all periods of unemployment. Use back page for additional space.
Your Job Title Dates of Employment - Give Month and Year
From To
Employer Type of Business
Hourly or Annual Pay:
Start
End
Address Supervisor's Phone Number
( ) -
Name and Title of Immediate Supervisor May we contact your supervisor for
reference? Yes
❏ No ❏
Description of Duties
Reason for seeking other employment?
P
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P
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List any special skills, or other information related to the position you are applying for (include courses, special training, equipment operated,
memberships, volunteer work, etc.)
Can you perform the essential duties of the position, as outlined in the job announcement? Yes ❏ No ❏
Continued
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Your Job Title
Employer Type of Business
Dates of Employment - Give Month and Year
From To
Hourly or Annual Pay:
Start End
Address Supervisor's Phone Number
( ) -
Name and Title of Immediate Supervisor May we contact your supervisor for
reference? Yes ❏ No ❏
Description of Duties:
Reason for seeking other employment?
If an employment offer is extended, I agree to submit to a physical examination (if job-related) by a physician designated by the City
at the City's expense, as a condition of employment. I also agree to submit to a Criminal History Background investigation and drug screening
(which are required of City employees); both of which will be performed at the City's expense.
I hereby affirm that the information on this application for employment is true and accurate to the best of my knowledge and belief, and
that I have not knowingly withheld any facts or circumstances that would, if disclosed, affect my application unfavorably. I understand that
providing false information on this form may result in disqualification or dismissal from employment.
While the filing of an application is the preliminary step to employment, it does not imply that I am bound to accept employment, nor
eventually will be employed. I give the City of Falls Church the right to check with former employers and to secure any additional information
from any source as necessary.
A newly appointed employee is required to complete a probationary period which is normally one year. During this period the employee
may be separated without appeal. The probationary period is considered the last stage of the selection process.
I hereby agree, as a condition of employment or continued employment, to give the City permission to obtain an abstract of my driving
record, if driving is a function of the job, from the Division of Motor Vehicles of the Commonwealth of Virginia or any other state in which I
have resided or from which I have held a motor vehicle operator's license.
Applicant's Signature Date
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER.
How did you learn about this position?
❏ City Web Site ❏ The Washington Post ❏ Recruitment Announcement
❏ Federal/State Employment Services ❏ The Examiner Washington ❏ Employee Referral. Please
state name of employee:
❏ Walk-in ❏ Falls Church News-Press
Newspaper ❏ Other, Please Specify:
List two professional references familiar with your recent work whom we may contact:
1. Name Phone
Number:
Position Title: Company
Name:
2. Name Phone
Number:
Position Title: Company
Name:
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Application Complete The Online Application (City of Falls Church)

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Completed 16 July 2020

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