Fillable Application for Employment (Illinois State Treasurer's Office)

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Application for Employment (Illinois State Treasurer's Office)

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The Application for Employment (Illinois State Treasurer's Office) form is 4 pages long and contains:

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  • 0 check-boxes
  • 115 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Illinois State Treasurer's Office

BROWSE ILLINOIS STATE TREASURER'S OFFICE (IL) FORMS

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Applicants are considered for all positions without regard to race, color, religion, sex, national origin, sexual
orientation, age, marital or veteran status, or the presence of a non-job related medical condition or disability.
Application for Employment
PLEASE PRINT
Position(s) Applied for ____________________________________________________
Date
_____________
Name ______________________________ _______________________________ _____ __________________
Last First Middle
Street Address _____________________________________________________________________________
City _________________________________________ State __________ Zip Code __________________
Telephone (_______)____________________
Area Code
Email ______________________________________________
If you are under the age of 18 can you furnish a work permit? Yes No
Have you filed an application here before? ˜Yes ˜No If yes, give date(s) _________________
Have you ever been employed here before? ˜Yes ˜No If yes, give date (s) _________________
Are you currently employed? ˜Yes ˜No
Are you lawfully authorized to work in the United States? ˜Yes ˜No
On what date would you be available to start work? ________________________________________ What
is desired or expected salary? Monthly _________________ Annual __________________
Are you able to work... Full-Time Part-Time Temporary
Are you on a layoff and subject to recall? Yes No
Can you travel if a job requires it? ˜Yes ˜No
How did you hear about this position? Check one:
Internal Posting/Walk in Internet Posting
Advertisement(specify)__________________________________________________________________________
Personal Contact(specify)________________________________________________________________________
Other
(specify)_________________________________________________________________________________
*AN EQUAL OPPORTUNITY EMPLOYER *
Employment Experience
Start with your present or last job going back fi ve years. If you need additional space, please continue on a
separate sheet. Please attach a copy of your current resume.
Employer
Job Title
Address
Duties Performed
Supervisor
Dates From To
Reason for leaving
Employer
Job Title
Address
Duties Performed
Supervisor
Dates From To
Reason for leaving
Employer
Job Title
Address
Duties Performed
Supervisor
Dates From To
Reason for leaving
Are you a member of the National Guard or a veteran of the U.S. military service? Yes No
If yes, branch: __________________________________________________________________
Dates of service: ________________________________________________________________
Are you currently in compliance with all state and federal income tax requirements? Yes No
If your answer to any of the following questions is “Yes,” please attach a signed, detailed explanation.
Have you ever been fi red from a job? (downsizing/layoff is not applicable) Yes No
Are you currently involved in any litigation? Yes No
Do you owe any back taxes? Yes No
Are you in arrears on child support payments? Yes
No
Are you currently in default on the repayment of any educational loan? Yes No
Indicate languages you speak, read, and/or write.
Fluent Good Fair
Speak
Read
Write
List professional, trade, business, or civic activities and offi ces held.
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Give names, addresses, and telephone numbers of three references (do not include relatives).
May we contact your present employer? Yes No
Name of contact: ____________________________________ Phone: ________________________________
Name Address Phone Number
1.
2.
3.
Special Skills and Qualifi cations
Summarize special skills and qualifications acquired from employment or other experience, such as computer
skills, etc. _________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Education
High School
College/University
Graduate/
Professional
School Name
Years Completed
(Circle)
9 10 11 12 1 2 3 4 1 2 3 4
Diploma/Degree
Description Course
of Study:
Honors Received
Describe specialized training, apprenticeship, skills, and extra-curricular activities. _______________________
__________________________________________________________________________________________
State any additional information you feel may
be helpful to us in considering your application. __________
__________________________________________________________________________________________
__________________________________________________________________________________________
APPLICANT’S 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. I understand that this application is not, and is not
intended to be a contract of employment.
In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge or other disciplinary action. I understand that if hired I am
required to abide by all rules and regulations of the Office of the Illinois State Treasurer. I understand that if hired I authorize the State of Illinois to conduct an investigation into all aspects of my
qualifications and background; any individual, organization, or agency that maintains records relating to me to provide these records upon request to any agency of the State Illinois conducting such as
investigation. This authorization is not limited to employment records,credit records, and criminal history records. I release any individual, organization, or agency from any and all liability incurred as a
result of providing such records. Proof of citizenship or immigration status will be required upon employment. If an adverse employment decision is made in whole or part regarding the information on
the credit report that is run by any duly authorized State of Illinois Agent procures, the Office of the State Treasurer will: 1. Give me a copy of the credit report; 2. Provide me with a summary of my
rights under the Fair Credit Reporting Act; 3. Provide me with the name of the credit reporting agency so that I may contact them if I choose to do so.
_______________________________________________________
Signature of Applicant
_________________________
Date
Mail or hand deliver your completed Application for Employment to the
Office of the Illinois State Treasurer, Department of Human Resources,
or
James R. Thompson Center
100 West Randolph, Suite 15-600
Chicago, Illinois 60601
Illinois Business Center
400 West Monroe Street, Suite 401
Springfield, IL 62704
4
4
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Application for Employment (Illinois State Treasurer's Office)

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Completed 20 July 2020

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