Fillable City Application ? Job Application (City of Aztec)

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City Application ? Job Application (City of Aztec)

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The City Application ? Job Application (City of Aztec) form is 6 pages long and contains:

  • 3 signatures
  • 41 check-boxes
  • 110 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Aztec

BROWSE CITY OF AZTEC (NM) FORMS

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1
2014-04
APPLICATION
For Employment with the City of Aztec
We consider applicants for all positions without regard to race, color, religion, sex, national origin, age,
disability, sexual orientation and gender identity, ancestry, physical or mental handicap,
serious health condition, spousal affiliation or any other legally protected status.
City of Aztec is an Equal Opportunity Employer.
PLEASE PRINT
Position Applied:
Date of Application:
How did you learn about us?
Advertisement Friend City Website
Employee Agency Relative Facebook / Twitter
LinkedIn / Professional Publication Other
Last Name
First Name
Middle Name
Physical Address
City
State
Zip Code
Mailing Address
City
State
Zip Code
Telephone Number (s)
E-Mail
Best time to contact you?
AM
To
If you are under 18 years of age, can you provide
required proof of your eligibility to work?
NO YES
Have you ever filed an application with us before?
NO YES
Date:
Have you ever been employed with us before?
NO YES
Date:
Do you have relatives employed by the City of Aztec?
NO YES
Name:
Do you possess a valid Driver's License?
NO YES
State
Class
License #
2
2014-04
Are you currently employed?
NO
YES
Are you prevented from lawfully becoming employed in this
country because of Visa or Immigration Status?
NO
YES
(Proof of citizenship or immigration status will be required upon employment)
Date available for work:
Are you available to work:
Full-time
Part-time
Temporary
EDUCATION
School Name & Address of School Course of Study Completed
# Years
Attended
Diploma / Degree
High School
Undergraduate College
Graduate/Professional
Other (specify)
3
2014-04
Why do you want to work for the City of Aztec?
PROFESSIONAL REFERENCES
Name
Phone Number
Best time to call
Employer/Occupation
1.
2.
3.
(Do not include family members)
4
2014-04
WORK EXPERIENCE
Please complete even if Resume is attached. Start with your present or most current employment.
Include any job-related military service assignments and volunteer activities. You may exclude organizations that indicate
race, color, religion, gender, national origin, disabilities or other protected status.
Employer
Dates Employed
Work Performed
Address
From To
Starting/Present Job Title
Hourly Rate/Salary
Starting Pay Final Pay
Supervisor
Reason for Leaving
May we contact? No Yes Phone #:
Employer
Dates Employed
Work Performed
Address
From To
Starting/Present Job Title
Hourly Rate/Salary
Starting Pay Final Pay
Supervisor
Reason for Leaving
May we contact? No Yes Phone #:
Employer
Dates Employed
Work Performed
Address
From To
Starting/Present Job Title
Hourly Rate/Salary
Starting Pay Final Pay
Supervisor
Reason for Leaving
May we contact? No Yes Phone #:
Employer
Dates Employed
Work Performed
Address
From To
Starting/Present Job Title
Hourly Rate/Salary
Starting Pay Final Pay
Supervisor
Reason for Leaving
May we contact? No Yes Phone #:
Please attach additional pages if necessary for Work Experience.
5
2014-04
Describe Any Specialized Training, Apprenticeship, Skills, and Extra-Curricular Activities
List Professional, Trade, Business or Civic Activities and Offices Held
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or
other protected status.
ADDITIONAL INFORMATION/OTHER QUALIFICATIONS
Summarize special job-related skills and qualifications acquired from employment or other experience.
SPECIALIZED SKILLS
(Check skills/Equipment Operated)
Switchboard
CDL License
Type/State:
Machinery (list) Other (list)
PC computer
Certified Law
Enforcement
Keyboard-Typing
WPM:
Equipment Operator
(list equipment EHORZ
Spreadsheet
Word Processing
State any additional information you feel may be helpful to us in considering your application.
List all computer programs you are familiar with.
SUBSTANCE ABUSE POLICY STATEMENT
The City of Aztec recognizes alcohol and drug abuse as potential health, safety, and security problems. We expect all
employees to assist in maintaining a work environment free from the effects of alcohol, drugs, or other intoxicating
substances. Compliance with this substance abuse policy is made a condition of employment.
SCREENING CONSENT FORM
I fully understand that, should I be offered employment by the City of Aztec, a pre-employment urine drug
screen will be required. The urine specimen collected may be analyzed for the following substances or classes
of substance:
Amphetamines
(methamphetamine and amphetamine)
Barbiturates
(Phenobarbital, secobarbital, etc.)
Opiates
(heroin, morphine, codeine, etc.)
Benzodiazepines
(Librium, Valium, and oxazepam)
Cannabinoids
(marijuana and hashish)
Propoxyphene
(Darvon)
Phencyclidine
(PCP, anabolic steroids)
I understand that my refusal to submit to and cooperate fully in this drug screen shall constitute good and
sufficient cause for withdrawal of this application from further consideration.
I agree to the disclosure of the results of such tests to the hiring agency by the testing facility. I understand
that a positive test result will be a factor in the employment decision and may result in my rejection for
consideration for employment with the hiring agency.
I agree to release the City of Aztec and the drug testing facility from any liability. The City of Aztec agrees that
the test results will not be provided to law enforcement authorities without the applicant's written consent.
I also understand that, should I be offered employment by the City of Aztec, the City will require that I pass a
physical examination, scheduled and paid for by the City.
Applicant’s Signature:
Date:
APPLICANT REFERENCE CHECK AUTHORIZATION
I understand that my work history may be verified. I authorize the City of Aztec agent to contact the references
that I have listed in the work history in order to verify the information I have provided. I agree to release former
employers, the City of Aztec, or any others from any liability that might arise from the disclosure of information.
Applicant’s Signature:
Date:
FALSIFICATION OF APPLICATION
I understand that by signing below I certify that all information stated on the application is true. I further
understand that falsifying records is a serious offense and may result in termination if I am hired by the City of
Aztec.
Applicant’s Signature:
Date:
FOR HUMAN RESOURCES ONLY
Record of Receipt
Date: Time: By:
6
2014-04
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City Application Job Application (City of Aztec)

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Completed 14 July 2020

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