JOB APPLICATION
City of Marion Illinois
1102 Tower Square Plaza, Marion, Illinois 62959
618.993.6603
The City of Marion, Illinois is an equal opportunity employer. This application will not be used for limiting
or excluding any applicant from consideration for employment on a basis prohibited by local, state, or
federal law. Should an applicant need reasonable accommodation in the application process, he or she
should contact a company representative.
Applicant Information
Applicant Name:
Date of Application:
Employment Position
Position(s) applying for: _____________________________________________________________
How did you hear about this position?
What days are you available for work?
What hours or shift are you available for work?
If needed, are you available to work overtime?
On what date can you start working if you are hired?
Salary desired:
Personal Information
Have you ever applied to or worked for City of Marion, Illinois before? Yes No
If yes, when?
Do you have any friends, relatives, or acquaintances working for City of Marion, Illinois? Yes No
If yes, please list their name and relationship to you:
Address:
City, State and Zip Code:
Telephone Number:
Are you 18 years of age or older? Yes No
Are you a U.S. citizen or approved to work in the United States? Yes No
What documentation can you provide as proof of citizenship or legal status?
______________________________________________________________________________________
Do you consent to a mandatory controlled substance test? Yes No
Job Skills/Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying:
_____________________________________________________________________________________
Education and Training
High School
Name
Location (City, State)
Year Graduated
Degree Earned
College/University
Name
Location (City, State)
Year Graduated
Degree Earned
Vocational School/Specialized Training
Name
Location (City, State)
Year Graduated
Degree Earned
Military
Are you a member of the Armed Services?
What branch of the military did you enlist?
What was your military rank when discharged?
How many years did you serve in the military?
What military skills do you possess that would be an asset for this position?
Previous Employment
Employer Name:
Job Title:
Supervisor Name:
Employer Address:
City, State and Zip Code:
Employer Telephone:
Dates Employed:
Reason for leaving:
Employer Name:
Job Title:
Supervisor Name:
Employer Address:
City, State and Zip Code:
Employer Telephone:
Dates Employed:
Reason for leaving:
Employer Name:
Job Title:
Supervisor Name:
Employer Address:
City, State and Zip Code:
Employer Telephone:
Dates Employed:
Reason for leaving:
References
Please provide 3 personal and professional reference(s) below:
Reference
Contact Information
Additional Information
Specialized Skills
List professional, trade, business or civic activities and offices held
Other qualifications
** PLEASE NOTE: No applicant is obligated to disclose any expunged records, adjudication or arrest while
they were a juvenile pursuant to Illinois Public Act 100-0285, including any ordinance violations.
Furthermore, any information obtained through this application process regarding any expunged juvenile
record is confidential and will NOT be disclosed in any manner by the City.
Applicant Signature: ___________________________________________ Date: ___________________
For Office Use Only
Reviewed by______________________ Date_________________
Interviewed by____________________ Date_________________
Pre-Employment Screening Scheduled
Employment Application and Authorizations Forwarded to HR
Drug Test Complete Background Check Complete
New Hire Information Given to City Clerk for Agenda
Council Approval Date: _______________________________
click to sign
signature
click to edit
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