City of
EMPLOYMENT APPLICATION
Position title(s): Please identify the specific position(s) from our openings for which you are applying.
1.) 2.)
Days available:
Times available:
GENERAL INFORMATION
Last Name First Name Middle Initial
Home Phone Work Phone Cell Phone
E-mail
Address City
State Zip Code County How long?
Do you have a valid Driver's License? Yes No State Expiration Date
Is license current?
Have you ever
been found guilty of a felony?
If yes, please explain:
If hired, can you provide the necessary documents to verify your lawful right to work in the United States?
Are you related to any employee of the City of Woodstock or an elected official?
(Pursuant to policy, employee may not work within a "relative's" span of control.)
If yes, state their name and relationship:
Have you ever been previously employed by the City of Woodstock?
When?
Were you referred by a City of Woodstock employee?
If yes, please state the employee's name
Are you at least 18 years of age?
(Min. age requirement for certain positions within the City.)
How did you hear about the opening?
In what capacity?
If seeking
part-time
employment
Do you have a CDL?
Please complete all applicable information as requested in this application and submit electronically with other requested application
materials to hrdept@woodstockil.gov. Walk-in, faxed or USPS mailed applications will not be accepted.
City of Woodstock - Human Resources - 121 W. Calhoun Street - Woodstock, IL 60098
Phone: (815) 338-1172 Fax: (815) 338-2264 Email: hrdept@woodstockil.gov
INSTRUCTIONS FOR COMPLETING THIS EMPLOYMENT APPLICATION
We welcome you as an applicant for employment with the City of Woodstock. It is the policy and intent of the City to provide equal
opportunity in employment to all persons. All information contained in or connected with this application will be considered personal and
confidential and used only in conjunction with possible employment with the City of Woodstock. This application will be considered
inactive after the position is filled. If you wish to be considered for future openings, submit an Interest Card at www.woodstockil.gov.
Date
Available:
Full-time Part-time Temporary
Seasonal
Yes
No
Yes No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
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LPT Customer Service Attendant - Woodstock Recreation Center
EDUCATIONAL INFORMATION
Major / Area of Study
College/University
College/University
Graduate School
Technical/Business
If you are not a high school graduate, have you passed the GED test?
List any community service projects or experience you have had.
List any additional languages spoken, special courses, seminars, workshops, etc., that might relate to this position.
List any licenses or certificates relating to this position.
EMPLOYMENT HISTORY
Please begin with your present or most recent employer and provide all the information requested.
Please do not write - "SEE RESUME"
May the City of Woodstock contact your current employer?
Employer: Phone Number:
Address: City: State: Zip Code:
Dates of Employment:
Position:
Duties
:
List any professional, trade, or business associations to which you belong.
Supervisor's Name:
Reason for Leaving:
Name and Location of SchoolType of School Degree Earned
High School
Other
Hours per Week:
Yes
No
Yes
No
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Do NOT indicate salary
EMPLOYMENT HISTORY CON'T...
Employer: Phone Number:
Address: City: State: Zip Code:
Dates of Employment:
Position:
Duties:
Employer: Phone Number:
Address: City: State: Zip Code:
Dates of Employment:
Position:
Duties:
REFERENCES
Name: Business:
Relationship: Phone:
Years Know
n
Name: Business:
Relationship: Phone:
Years Know
n
Name: Business:
Relationship: Phone:
Years Know
n
Supervisor's Name:
Reason for Leaving:
Hours per Week:
Please list three references that are familiar with your work history and/or experience as a volunteer. These can be employers
customers, co-workers, teachers or coaches. They should not
be relatives.
Hours per Week:
Reason for Leaving:
Supervisor's Name:
Page 3 of 4
Do NOT indicate salary
Do NOT indicate salary
APPLICANT AGREEMENT: RELEASE AND CERTIFICATION
DATE
If hired and in consideration of employment, I agree to abide by all applicable City of Woodstock ordinances, rules and
regulations. I understand and agree that, if hired, my employment is for no definite period of time and regardless of the
date for payment of wage or salary, I may be terminated at anytime, with or without cause or prior notice.
I understand that all candidates hired are subject to satisfactory completion of a probationary period and may be subject
to a post-offer, pre-employment physical exam and drug screen. I authorize the investigation of all statements and
information contained in this application. I release the City of Woodstock from any and all liability that might result fro
m
conducting a background investigation.
PRINT NAME
SIGNATURE
I acknowledge that I have read the above statements and hereby grant permission to verify the information supplied on
this application for employment and employment-related documents I have provided.
I hereby certify that all answers to the questions herein are true, accurate and complete to the best of my knowledge. I
agree and understand that any false statements, misrepresentations or omissions of fact contained in the application (or
any other accompanying or required documents) may cause the rejection of this application or termination of
employment without notice or benefits, regardless of how or when discovered.
Please read before signing. Questions regarding this statement should be directed to any employment interviewer prior
to signing.
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click to sign
signature
click to edit