Fillable EMPLOYMENT APPLICATION (State of Delaware)

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EMPLOYMENT APPLICATION (State of Delaware)

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The EMPLOYMENT APPLICATION (State of Delaware) form is 5 pages long and contains:

  • 1 signature
  • 10 check-boxes
  • 127 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of Delaware

BROWSE STATE OF DELAWARE (DE) FORMS

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EMPLOYMENT APPLICATION
For Direct Hire, Casual Seasonal, and Career Ladder Promotions ONLY
Name
Last First Middle Initial
Mailing Address, City, State & Zip E-mail Address:
Home Phone:
Business Phone:
May we call you at work? Yes No
Cell Phone:
Job Applied for (Title) Job Location:
Present State of Delaware Employee Yes No Merit Other Seasonal
Past State of Delaware Employee Yes No Merit Other Seasonal
State of Delaware Pensioner
(Receiving a Pension Check)
Yes No Retirement date
Driver’s License (State)
Type: Number:
Expiration Date:
Employment Dismissals: Have you been involuntarily discharged or forced to
resign from State employment in the last 3 years? If yes, give details:
Yes No
The State requires verification of identity and eligibility for employment in the United States.
Are you lawfully permitted to work in the United States beyond a temporary period
without employment based sponsorship?
Yes No
If you are a male, born after January 1, 1960, have you registered for Selective Service,
if required to register? Proof of registration may be required.
Yes No
Personnel Use Only
JR’s __Yes __No
Comments:
Rater:____Date:____
R 9/2017 Page 2 of 5
EDUCATION/TRAINING
Have you graduated from high school or passed the G.E.D.? Yes No
Have you attended vocational and/or business school? Yes No
Did you attend college, universities, or other technical schools beyond high school?
Yes No
If yes, give complete information in table below:
*A degree, as part of the Job Requirements, must have been issued from an accredited college or university in
order to meet the Job Requirements.
School Name Location Dates
Attended
Major/Minor Type of
Degree
Received
Please list currently valid certification of professional or vocational competence/licenses and expiration date.
Other Job-Related Training:
License/Certification Registration Type Issued by/Number Expiration Date
Course Title Training Provider Dates Attended
R 9/2017 Page 3 of 5
EMPLOYMENT HISTORY
Are you employed now? Yes No
Beginning with your current or most recent position, state your employment history. A resume does not
substitute for this section of the application. This section must be completed.
Employed Job Title: Hourly or Annual
From: Employer: Salary:
Location: Start:
MO/DD/YR
Supervisor Name: End:
To: Supervisor Title:
Supervisor Phone No.:
MO/DD/YR
Reason for Leaving:
Describe your duties:
Employed Job Title: Hourly or Annual
From: Employer: Salary:
Location: Start:
MO/DD/YR
Supervisor Name: End:
To: Supervisor Title:
Supervisor Phone No.:
MO/DD/YR
Reason for Leaving:
Describe your duties:
Employed Job Title: Hourly or Annual
From: Employer: Salary:
Location: Start:
MO/DD/YR
Supervisor Name: End:
To: Supervisor Title:
Supervisor Phone No.:
MO/DD/YR
Reason for Leaving:
Describe your duties:
R 9/2017 Page 4 of 5
JOB REQUIREMENTS
Please describe how your education, training, and experience meet each Job Requirement and/or Preferential
and Selective described in the Job Announcement. Please do not submit copies of letters or training certificates,
unless stated as a requirement.
Use additional pages if needed
R 9/2017 Page 5 of 5
APPLICANT RELEASE OF EMPLOYMENT INFORMATION
READ THIS STATEMENT BEFORE SIGNING THIS APPLICATION:
Information provided on this application may be verified, including, but not limited to, contacting former
employers. Any false or substantive omission of information may be cause for rejection or dismissal if
employed by the State.
I authorize the release of any information from previous employers or references. If I am a current or former
employee of the State of Delaware, I acknowledge that my personnel records shall be subject to review by the
hiring agency.
By signing this application, I certify agreement with the terms given above for Applicant Release of
Employment Information.
By signing this application, I certify that I have read and understand the conditions of employment as stated
below. I also certify that this application was completed by me, that all entries on it are true, and that I seek
employment under these conditions.
Child Support Compliance: State law requires that information on all hires (i.e. Name, Address, Social
Security Number, and Date of Hire) be reported to the State for the purpose of locating persons who owe
family support. The Division of Child Support Enforcement is authorized to request additional
employment and identifying information under special circumstances. Applicants will not be
disqualified from employment based on this information.
Direct Deposit: As a condition of employment, direct deposit of paychecks is required for all new
employees.
Immigration Law: At the time of hire, state employees must meet the documentation requirements of the
Immigration Reform and Control Act of 1986.
Reference Check: Prior to appointment, your education and employment history are subject to
verification. At the time of a selection interview, candidates may be required to provide copies of
certificates, licenses, diplomas, and course transcripts.
Signature Date
An Equal Opportunity Employer
Accommodations are available for applicants with disabilities in all phases of the application and
employment process. To request auxiliary aid or service, please call (302) 739-5458 for assistance. TDD
users should call the Delaware Relay Service Number 1-800-232-5460 for assistance.
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EMPLOYMENT APPLICATION (State of Delaware)

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Completed 20 July 2020

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