City of Maroa
120 S Locust Street
Maroa, IL 61756
Phone: (217) 794-2206 / Fax: (217) 794-5125
APPLICATION FOR EMPLOYMENT
We consider applicants for all positions without regard to race, color, religion, creed, gender,
national origin, age, disability, marital or veteran status, or any other legally protected status.
Date of Application:
Last First Middle
Street City State Zip
Phone Number: Driver's License Number:
Position(s) Applied For:
How Did You Learn About Us?
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Date You Can Start: Salary Desired:
Are You Employed Now: If So, May We Contact Your Employer:
Do any of your friends or relatives, other than your spouse, work here? Yes No
Part Time Temporary
If yes, state name, relationship, and position:
Are you available to work: Full Time
Can you travel if a job requires it?
Are you currently on temporary leave?
Are you subject to recall?