Fillable EMPLOYMENT APPLICATION (Fountain Hills Sanitary District)

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EMPLOYMENT APPLICATION (Fountain Hills Sanitary District)

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PROPERTY INFORMATION (Fountain Hills Sanitary District)

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EMPLOYMENT APPLICATION

(Please Print or Type)

Applicants for all positions are considered without regard to race, creed, color, religion, gender, national origin, age, disability,

marital or veteran status, or any other legally protected status.

PERSONAL INFORMATION:

Full Name: ________________________________________________________________________

Are

you under age 18? [ ] Yes [ ] No Social Security Number: _____/_____/_____

Mailing Address: _____________________________________ City/State/Zip Code: ______________________________________

Home Phone: _______

_________________ Cell Phone: ____________________________

Email Address: ____________________________________________________________________

[ ] Yes [ ] No

CURRENT EMPLOYMENT STATUS:

Are you currently employed?

May we contact your

present employer?

Are you legally eligible for employment in the USA

(Proof of citizenship or immigration status will be required upon employment)

AVAILABILITY:

Check

which boxes apply: [ ] Full Time [ ] Part Time [ ] Shift Work [ ] Temporary

your application is considered favorable, what date would you be available for work? ___/___/___

Can you travel if a job requires it? [ ] Yes [ ] No

ADDITIONAL INFORMATION:

Have you filed an application with Fountain Hills Sanitary District in the past?

[ ] Yes [ ] No

If Yes, give date and position applied for: ________________________________________________________________________

Have you ever been convicted of a felony?

[ ] Yes

[ ]

(Conviction will not necessarily disqualify an applicant from employment)

If YES, please explain: _______________________________________________________________________________________

FOUNTAIN HILLS SANITARY DISTRICT

16941 E. Pepperwood Circle

Fountain Hills, AZ 85268-2901

(480) 837-9444

Fountain Hills Sanitary District is an Equal Opportunity Employer & Service Provider

POSITION APPLYING FOR:

Position Title: ______________________________________________________________________ Date: _____/_____/_____

How did you learn about this opening? Advertisement Friend Walk-in Relative Other

Have you ever been employed with Fountain Hills Sanitary District?

If Yes, give date and position held: _________________________________________________________________________________________

[ ] Yes

[ ]

EDUCATION AND ADDITIONAL INFORMATION

NAME/ADDRESS COURSE OF STUDY # YEARS DEGREE

HIGH SCHOOL

_____________________________________ _________________________________ _______ _______

COLLEGE

OTHER

_____________________________________ _________________________________ _______ _______

___________________________________ _________________________________ _______ _______

_____________________________________ _________________________________ _______ _______

DESCRIBE ANY SPECIALIZED TRAINING, APPRENTICESHIP, OR OTHER SKILLS YOU FEEL WOULD ESPECIALLY

FIT YOU TO WORK WITH

FOUNTAIN HILLS SANITARY DISTRICT:

________________________________________________________________________________________________________

__________

______________________________________________________________________________________________

SUMMARIZE SPECIAL JOB RELATED SKILLS AND QUALIFICATIONS ACQUIRED FROM EMPLOYMENT OR OTHER

EXPERIENCE:

________________________________________________________________________________________________________

_________

_______________________________________________________________________________________________

_________

_______________________________________________________________________________________________

_________

_______________________________________________________________________________________________

_________

_______________________________________________________________________________________________

STATE ANY ADDITIONAL INFORMATION YOU FEEL MAY BE HELPFUL TO US IN CONSIDERING YOUR

APPLICATION:

_______

_________________________________________________________________________________________________

__________

______________________________________________________________________________________________

__________

______________________________________________________________________________________________

__________

______________________________________________________________________________________________

__________

______________________________________________________________________________________________

__________

______________________________________________________________________________________________

________________________________________________________________________________________________________

__________

______________________________________________________________________________________________

__________

______________________________________________________________________________________________

EMPLOYMENT HISTORY

DUTIES

DATE EMPLOYED

To:______________

From:____________

EMPLOYER

__________________________________________

ADDRESS

___________ _______________________________

TELEPHONE NUMBER

____________

______________________________

JOB TITLE

__________________________________________

SUPERVISOR

__________________________________________

REASON FOR LEAVING

__________________________________________

____________

________________________

____________________________________

WAGES/SALARY

To:_______________

From:_____________

EMPLOYER

________________________________________

ADDRESS

_________ _______________________________

TELEPHONE NUMBER

____________________________________

JOB TITLE

__________________________________________

SUPERVISOR

__________________________________________

REASON FOR LEAVING

__________________________________________

DATE EMPLOYED

To:______________

From:____________

____________

________________________

____________________________________

WAGES/SALARY

To:_______________

From:____________

DUTIES

DATE EMPLOYED

To:

______________

From:____________

EMPLOYER

___________

_______________________________

ADDRESS

___________ _______________________________

TELEP

HONE NUMBER

__________________________________________

JOB TITLE

_________________________________________

SUPERVISOR

__________________________________________

REASON FOR LEAVING

__________________________________________

____________________________________

__________

__________________________

____________________________________

__________

__________________________

__________

__________________________

____________________________________

WAGES/SALARY

To:_______________

From:_____________

EMPLOYER

____________

______________________________

ADDRESS

_________

__ _______________________________

TELEPHONE NUMBER

__________________________________________

JOB TITLE

__________________________________________

SUPERVISOR

__________________________________________

REASON FOR LEAVING

__________________________________________

DATE EMPLOYED

To:______________

From:____________

____________________________________

_____

_______________________________

____________________________________

WAGES/SALARY

To:

_______________

From:_____________

DUTIES

Have you ever had any job-related training in the United States military? Yes No

If yes, please describe: ______________________________________________________________________

________________________________________________________________________________________

ADDITIONAL INFORMATION

REFERENCES:

NAME RELATIONSHIP PHONE #

__________

_____________________________________________________________________________________________

_______________________________________________________________________________________________________

__________

_____________________________________________________________________________________________

I certify that answers given herein are true and complete to the best of my knowledge and understand all

answers

must be true and complete to the best of my knowledge to be considered for employment, which

consideration is a privilege or benefit.

I authorize investigation of all statements contained in or related to this application for employment. I

understand all answers given herein are made to Fountain Hills Sanitary District, it’s agents and public

servants

reviewing this application and authorize disclosure of information contained in the application or

discovered by investigation to Fountain Hills Sanitary District and my employing officer, agency or

department and as otherwise provided by law.

In the event of employment, I understand that falsification, misrepresentation, and/or omission on my

application or inte

rviews may result in discharge.

hereby understand and ackn

owledge that, unless otherwise defined by applicable law, any employment

elationship with this organization is of an "at will" nature, which means that the Employee may resign at

any time and the Employer may d

ischarge Employee at any time w

ith or without cause. It is further

understood that this "at will" employment relationship may not be changed by any written document or by

conduct unless such change is specifically acknowledged in writing by an authorized executive of this

organization. I understand, also, that in the event of employment, I am required to abide by all lawful rules

and regulations of Fountain Hills Sanitary District and my employing officer, agency, or department.

_____/_____/_____

DATE

___________________________

___________

APPLICANT’S

IGNATURE

Are you physically or otherwise unable to perform the duties of the job for which you are applying?

[ ] Yes [ ] No

EMPLOYMENT APPLICANT’S

AUTHORIZATION FOR BACKGROUND INVESTIGATION

AND RELEASE FROM LIABILITY

I, ___________________________________, hereby authorize Fountain Hills Sanitary

District, its Officers, employees, or agents, to investigate my background, including but

not limited to, my employment, criminal and academic history and my credentials. I

further authorize any present or former employer, college, university, school, person or

legal entity, its officers, employees or agents, concerning any information, records, files

or opinions they may have regarding my present or past employment or academic

histories, including, but not limited to, my ability to work with other, reputation for

honest, disciplinary actions, work habits and performance.

I hereby release from liability and agree to hold harmless under any and all possible

causes of legal action, Fountain Hills Sanitary District, its officer, employees and agents,

as well as any

present or former employer, college, university, school, person or legal

entity, its officers, agents or employees for any statements, acts, or omissions made in the

course of the investigation.

This release from liability shall apply to any right of action that might accrue to myself,

my heirs, assigns and personal representatives.

A photo copy of this document shall have the same effect as the original.

I HAVE READ AND FULLY UNDERSTAND THE ABOVE AND AGREE TO ITS

CONTENTS AS STATED.

________________________________________ _____/_____/_____

Signature of Applicant Date

________________________________________

Applicant's Printed Name

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EMPLOYMENT APPLICATION (Fountain Hills Sanitary District)

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Completed 20 July 2020

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