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City of Ecorse
City of Friendship
INSTRUCTIONS ON APPLYING FOR CITY EMPLOYMENT
Read the following instructions carefully before completing the attached application.
Failure to follow these instructions could affect your opportunity for employment.
1. CHECK TO BE SURE THAT YOU HAVE THE NECESSARY FORMS.
In addition to this information sheet, you should also have the following: an "Application for
Employment", the official job announcement describing the position for which you are applying, and a “Consent Form
for the Release of Information”.
2. READ THE JOB ANNOUNCEMENT THOROUGHLY.
The job announcement provides you with the following essential information:
a) The official job title, which is the title that you should use on the application;
b) The duties and responsibilities expected of you if hired;
c) The knowledge, abilities and skills required to perform the work;
d) The education and/or work experience required in order to be considered for this position;
e) Any special licenses or certificates required;
f) The deadline by which your application must be received in the Human Resource Department.
If you meet the qualifications and are interested in the type of work described, complete the
application as instructed below. If not, you may wish to review the bulletin board in the hallway just outside the
entrance to the Human Resource Department or online at: http://www.ecorsemi.gov to see if there other jobs posted
for which you are qualified.
3. PRINT OUT AND COMPLETE THE OFFICIAL APPLICATION FORM.
Applications must be completed in full even if you attached a resume. Type or print legibly in dark ink. Do not answer
questions on the application by saying "see resume". Failure to accurately and completely fill out this application
could affect your opportunities for employment. If you need more space for an answer, attach an 8.5x11 sheet of
paper, and write your name in the upper right hand corner. Be sure to sign and date the application at the end in the
space provided.
4. ATTACH DOCUMENTATION OF EDUCATION, LICENSES, PERMITS AND CERTIFICATIONS TO MEET BASIC
REQUIREMENTS AS SPECIFIED IN THE JOB DESCRIPTION AND FOR EXTRA CREDIT WHERE APPLICABLE.
For example, if one or more years of college is required, attach a copy of transcripts and any degree received. If your
education exceeds the minimum requirements, it is recommended that you submit a copy of the highest degree
attained and any related transcripts by the closing date or as soon as possible. If the job announcement specifies that
a certain type of education, license, certification, permit or registration is required, please submit a copy of evidence
thereof.
5. FILL OUT THE CONSENT FORM FOR RELEASE OF CRIMINAL HISTORY CONVICTION INFORMATION
AND DRIVING RECORD SHEET AND RETURN IT WITH YOUR APPLICATION.
The Consent Form for Release of Criminal History Conviction Information and Driving Record will be separated from
your application and used to run a basic criminal and driving record background check on applicants who meet the
minimum qualifications.
6. NEPOTISM POLICY
In order to avoid conflict of interest, favoritism and the appearance of same, no employee of the City of Ecorse shall
be placed in a position where he/she is required to supervise, evaluate or discipline an immediate family member or
receive supervision, evaluation or discipline from an immediate family member. Immediate family member includes
parent, spouse, child, sibling or in-law.
7. DISABILITY POLICY
Michigan law requires employers to make accommodations to applicants and employees with disabilities where the
accommodation does not impose an undue hardship on the employer. Employees and applicants may request an
accommodation of their disabilities by notifying the City in writing of the need for accommodation within 182 days of
the date that he/she knows or should know that an accommodation is needed. Failure to notify the City will preclude
any claim that the employer failed to provide accommodation.
PLEASE RETURN YOUR APPLICATION WITH ALL REQUIRED DOCUMENTATION TO THE HUMAN
RESOURCE DEPARTMENT BY THE DEADLINE STATED ON THE JOB ANNOUNCEMENT.
APPLICATIONS RECEIVED BY FAX OR EMAIL CAN NOT BE CONSIDERED UNTIL THE ORIGINAL,
SIGNED APPLICATION IS ON FILE WITH THE HUMAN RESOURCE DEPARTMENT.
PLEASE DO NOT INCLUDE (COPIES OF) PHOTO I.D.’S OR SOCIAL SECURITY CARDS.
DO NOT RETURN THIS INSTRUCTION SHEET OR JOB DESCRIPTION WITH YOUR APPLICATION.
APPLICATION FOR EMPLOYMENT
CITY OF ECORSE
HUMAN RESOURCE DEPARTMENT
3869 W. Jefferson
ECORSE, MICHIGAN 48229
PHONE # 313-386-2520
INSTRUCTIONS: Type or print in ink. Complete all questions, even if you enclose a resume. Extra pages may be attached if you
need them. If required in the Job Announcement, please provide all proofs of education or certifications. The original, signed form
(no scan, copy or fax) may be turned in at the Human Resource Department or mailed to the address above.
STATE EXACT TITLE OF POSITION FROM THE JOB ANNOUNCEMENT
DATE OF APPLICATION
DATE AVAILABLE FOR WORK
LAST NAME
FIRST NAME
ADDRESS
CITY
STATE
HOME PHONE (INCLUDING AREA CODE)
CELL/MOBILE PHONE (INCLUDING AREA CODE)
EMAIL ADDRESS
DO YOU HAVE A VALID DRIVER’S LICENSE?
(NOT REQUIRED FOR ALL POSITIONS)
YES NO
CLASS / TYPE (O – Operator; C – Chauffeur; CDL – Commercial Driver’s License, etc.)
ISSUED BY THE STATE OF
EXPIRATION DATE
DATES OF U.S. MILITARY SERVICE
FROM _________/_________ TO
_________/_________
BRANCH OF SERVICE
TYPE OF DISCHARGE
If you are claiming preference as a veteran, or as the spouse or child of
a disabled veteran, you must attach a copy of your discharge documents
and, if applicable, your V.A. disability letter and claim number.
CHECK THE BOX FOR EACH QUESTION
YES
NO
YES
NO
Are you legally authorized to work in the United States?
Can you provide documentation showing you're
authorized to work in the United States?
Have you ever been convicted of a crime other than a minor traffic
violation? If so, state when and the nature of the crime. (A yes
answer does not automatically disqualify you.)
Are there any felony charges currently pending against
you?
Are you at least 18 years old?
Have you ever been discharged or asked to resign from a position?
If yes – Explain fully using a separate sheet of paper, if necessary. (An
affirmative answer does not automatically disqualify you from employment)
Have you ever been employed by the City Of Ecorse?
If yes - What was your title? When?
EDUCATION
Name / Location
# of Years
Completed
Diploma or
Degree Y/N
Courses of Study
High School
College
College
Graduate
Vocational Training
SPECIAL SKILLS
What skill(s) or additional training do you have that is relevant to the job for which you are applying?
What machines or equipment can you operate that are relevant to the job for which you are applying?
Have you had any off-the-job training or experience which would help you in this job? For example: hobbies, school work, community groups, or
military experience?
List any licenses, registrations, or certifications you possess (i.e. CPA, Registered Engineer)
_ NAME (LAST, FIRST) ________________________ POSITION
HR USE ONLY
EDUCATION _________________
CERTIFICATION _________________
CONSENT _________________
E E O _________________
EMPLOYMENT EXPERIENCE
Begin with your present employer or your last job. List a promotion as a new job. List all employers. Attach extra pages if needed.
Employer Name
Telephone (Including Area Code)
Address
Dates of Employment
From
To
Your Job Title
Wages
Start
Last
Name and Title of Supervisor
Reason for Leaving
May we contact your present employer for a reference? Yes No
Employer Name
Telephone (Including Area Code)
Address
Dates of Employment
From
To
Your Job Title
Wages
Start
Last
Name and Title of Supervisor
Reason for Leaving
May we contact your previous employer for a reference? Yes No
Employer Name
Telephone (Including Area Code)
Address
Dates of Employment
From
To
Your Job Title
Wages
Start
Last
Name and Title of Supervisor
Reason for Leaving
May we contact your previous employer for a reference? Yes No
REFERENCES
List at least two responsible adults who have knowledge of your work ethic, experience, and ability.
Name
Address
Telephone # (Incl. Area Code)
Occupation
CERTIFICATION / SIGNATURE
Read Carefully Before Signing:
I certify that there are no misrepresentations, omissions, or falsifications in the foregoing statements and answers, and that the entries
made by me are true and complete.
I further agree and consent in advance that any misrepresentation or falsification of any of the above information shall be cause, without
any hearing, for rejection of this application, or termination of employment, depending upon when the falsification is discovered.
I also consent for the City of Ecorse to verify the information I have provided including my educational and professional certifications, and
check with previous employers. I release the City and previous employers from any liability arising from disclosure of information
concerning my past employment or personal history.
I agree and understand that any employment offer will be contingent upon the successful completion of a background investigation and
post-offer medical exam.
Further, I understand and agree that my employment is for no definite period of time and my employment and compensation can be
terminated at any time, with or without cause, with or without notice, at the option of either the employer or myself, unless otherwise
provided by union contracts, applicable handbook rules or written employment agreement signed by the City Administrator.
Signature ____________________________________________________________________ Date ____________________________
Revised 09/15 AN EQUAL OPPORTUNITY EMPLOYER
3869 W. Jefferson Avenue • Ecorse, MI 48229 • Phone Area Code (313)
www.ecorsemi.gov
City of Ecorse, MI
CONSENT FORM FOR RELEASE OF
CRIMINAL HISTORY CONVICTION INFORMATION & DRIVING RECORD
As a prospective employee or volunteer of the City of Ecorse, I understand that it is this entity’s policy to
secure conviction criminal history information as part of their pre-employment screening process using
the information provided below. I further understand that the personal data that I am providing will be
used for no other purpose and will not become a part of my employment file or volunteer file.
> > > > > > > PLEASE PRINT < < < < < <
NAME:
_____________________________________________________________________________________
FIRST NAME MIDDLE NAME (NOT JUST INITIAL) LAST NAME
MAIDEN NAME / OTHER NAMES PREVIOUSLY USED:
_____________________________________________________________________________________
DATE OF BIRTH: ___________________ RACE:____________________ SEX:_________
DRIVER’S LICENSE NUMBER: ___________________________________________________________
I understand that the Central Records Division of the Michigan State Police and the Michigan
…Secretary of State requires the above information.
I authorize the City of Ecorse to utilize the above information for the sole purpose of obtaining a
…criminal history conviction and driver’s license record search.
_________________________________________________________ ___________________
SIGNATURE DATE
POSITION
CLOSING DATE
H/R USE ONLY
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Completed 12 July 2020

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