Fillable Application For Employment (Burke County Georgia)

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Application For Employment (Burke County Georgia)

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The Application For Employment (Burke County Georgia) form is 4 pages long and contains:

  • 1 signature
  • 17 check-boxes
  • 95 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Burke County Georgia

BROWSE BURKE COUNTY GEORGIA (GA) FORMS
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Application For Employment
Burke County Board of Commissioners
PO Box 89 Waynesboro, GA 30830 706-554-2324
Last Name
First Name
Middle Name
Address City State Zip Code
E-Mail Address
Best Time To Contact You a.m./p.m.
If you are under 18 years of age, can you provide required proof of your eligibility to work?
Yes
No
Have you ever been employed by us before? Yes
No
If Yes, give date
Supervisor’s Name
Do any of your friends or relatives, other than your spouse, work here? Y
es
No
If yes, state name, relationship and location
Are you currently employed? Yes
No
May we contact your current employer? Yes
No
Telephone Numbers
We consider applicants for all positions without regard to race, color, religion,
creed, gender, national origin, age, disability, veteran status, or any other
legally protected status.
Position(s) Applied For
Date of Application
EQUAL OPPORTUNITY
EMPLOYER
DRUG-FREE WORK PLACE
2
Version 8.2011
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
Date Available for Work - - What is your desired salary range?
Can you travel if a job requires? Yes
No
Are you available to work?
FULL TIME
PART TIME
(morning or afternoon)
TEMPORARY
Please indicate available dates
Education
Name & Address of
School
Course of Study
Number of
Years
Completed
Diploma or
Degree
High School
Undergraduate
College
Graduate/
Professional
Other (specify)
Work Experience
Start with your present or last job. Include any job-related military service assignments
and volunteer activities. Please exclude organizations which indicate race, color, religion,
gender, national origin, disabilities or other protected status.
Employer
Dates Employed
To:
From:
Work Performed
Address
City
State & Zip
Telephone Number(s)
Hourly Rate/Salary
Starting:
Final:
Starting/Present Job Title
Supervisor
Reason for leaving
May we contact?
Yes
No
3
Version 8.2011
Employer
Dates Employed
To:
From:
Work Performed
Address
City
State & Zip
Telephone Number(s)
Hourly Rate/Salary
Starting:
Final:
Starting/Present Job Title
Supervisor
Reason for leaving
May we contact?
Yes
No
Employer
Dates Employed
To:
From:
Work Performed
Address
City
State & Zip
Telephone Number(s)
Hourly Rate/Salary
Starting:
Final:
Starting/Present Job Title
Supervisor
Reason for leaving
May we contact?
Yes
No
Comments: Include explanation of any gaps in employment.
Describe any specialized training, apprenticeship, skills, and extra-curricular activities.
List US Military, professional, trade, business or civic activities and offices held.
Please exclude membership which may reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status:
4
Version 8.2011
Note to Applicants: DO NOT ANSWER THIS QUESTION UNLESS YOU HAVE BEEN
INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE
APPYING.
Can you perform the essential functions of the job, for which you are applying, either with or without a
reasonable accommodation? Yes
No
Personal/professional references
Please do not include family members.
Name
Phone Number
Best Time to Call
Occupation
1.
2.
3.
Applicant’s Statement
I certify that answers given herein are true and complete.
I authorize investigation of all statements contained in this application for
employment as may be necessary in arriving at an employment decision.
I hereby understand and acknowledge that, unless otherwise defined by applicable
law, any employment relationship with this organization is 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.
In the event of employment, I understand that false or misleading information
given in my application or 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
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Application For Employment (Burke County Georgia)

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Completed 17 July 2020

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