Employment Application
City of Maryville
AN EQUAL OPPORTUNITY EMPLOYER
NOTICE TO APPLICANTS
We are proud to be a drug free workplace. Screening tests for illegal
drug use may be required before hiring and during employment.
This document is a public record and open to inspection by any
citizen of the State of Tennessee pursuant to TCA Section 10-7-503.
Human Resources
404 West Broadway
Maryville, TN 37801
(865) 273-3425
Nepotism policy prohibits hiring relatives of active City of Maryville employees. Minimum of a high
school diploma or equivalent required. Valid TN drivers license required. Positive identification will be
required. Attach any additional information or documents to this application.
Last Name ____________________________________ First _____________________ Middle ______________
Date of Application ___________________________________________________________________________
Applications are available only for open positions for which public notice has been made.
Please indicate the specific advertised position you are applying for in the space provided.
____________________________________________________________
How did you hear about this position?
___ Local
newspaper
___ City website ___ Referred by:
__________________________
___ Knoxville newspaper ___ Municipal building posting ___ Other: _______________________________
AUTHORIZATIONS
I authorize investigation of all statements contained in this application, and it is understood and agreed that any
misrepresentation by me in this application will be sufficient for cancellation of the application and/or for separation
from City service if I have been employed.
I hereby authorize any person or organization whose name I have given as reference, or by whom I have been
previously employed, to furnish the City of Maryville any information they may have concerning me, and I hereby
release all such persons and organizations from any claims for damages. I understand that a background check may
include social networking and on-line searches.
I hereby authorize investigation of my criminal record.
I agree, if employed, to abide by all the rules, regulations and ordinances in the City of Maryville.
I understand that the completion of this Application of Employment does not constitute an offer of employment.
I further understand that if I am employed by the City of Maryville this Application for Employment will not constitute
a contract of employment.
I understand that, if the position for which I may be hired involves driving City vehicles, proof of a valid driver’s
license is required at initial employment and that the City also requires me to notify Human Resources within
seventy-two (72) hours if there is a change of status of my driver’s license.
I certify that the information I have given is true and correct to the best of my knowledge.
DATE:SIGNATURE: ________________________________________ ______________________________________
REFERENCES
Please list persons, other than relatives or personal friends, who have knowledge of your character and/or abilities.
Name:
______________________________________ Relationship: _______________________________________
Phone:
_____________________________________ Years known: _______________________________________
Name:
______________________________________ Relationship: _______________________________________
Phone:
_____________________________________ Years known: _______________________________________
Name:
______________________________________ Relationship: _______________________________________
Phone:
_____________________________________ Years known: _______________________________________
Name:
______________________________________ Relationship: _______________________________________
Phone:
_____________________________________ Years known: _______________________________________
Signature:
_________________________________________ Date: _______________________________________
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PERSONAL
Email Address _________________________________ Phone Number ______________________________________
Present Address _______________________________ City ________________________ State _____ Zip __________
Are you over the age of 18? Yes ___ No ___
Federal and applicable state laws prohibit discrimination on the basis of age.
Are you legally eligible for employment in the United States? Yes ___ No ___
What date can you begin work? ___________________ Desired starting salary/rate: ___________________________
Have you ever applied for employment with the City of Maryville before: Yes ___ No ___
If yes; when, what job: ______________________________________________________________________________
Would you accept temporary work? Yes ___ No ___ Part-time work? Yes ___ No ___
Have you ever been convicted of a misdemeanor or felony? Yes ___ No ___
If yes, explain fully:__________________________________________________________________________________
Answering yes to this question does not automatically disqualify you from consideration for employment.
Do you have any relatives working for the City of Maryville?
Yes ___ No ___ Indicate relation _____________________________________________________________________
Do you hold a valid Tennessee Driver’s License? Yes ___ No ___ License No. ________________ State Issued ______
Complete only if applying for Police Officer or Firefighter:
Birth Date:______ / ______ /______ Are you a U.S. citizen? Yes ___ No ___
EDUCATION - TRAINING
High School Name and Location of School ___________________________________________________________
Course of Study_________________________________________ Number of Years Completed ___________________
Did you Graduate? Yes ___ No ___ Degree or Diploma ___________________________________________________
Business/Trade Technical Name and Location of School ________________________________________________
Course of Study_________________________________________ Number of Years Completed ___________________
Did you Graduate? Yes ___ No ___ Degree or Diploma ___________________________________________________
College Name and Location of School ________________________________________________________________
Course of Study_________________________________________ Number of Years Completed ___________________
Did you Graduate? Yes ___ No ___ Degree or Diploma ___________________________________________________
Graduate School Name and Location of School _______________________________________________________
Course of Study_________________________________________ Number of Years Completed ___________________
Did you Graduate? Yes ___ No ___ Degree or Diploma ___________________________________________________
If you did not complete high school, do you have a G.E.D. ? Yes ___ No ___
EMPLOYMENT
Please give accurate, complete full-time and part-time employment record. Start with present or most recent employer.
Present Company Name _____________________________________ Telephone (_____ ) ______________________
Address ________________________________City ______________________State __________ Zip ______________
Employed - (State month and year) From _____________________________ To
________________________________
Name of Supervisor _________________________ Salary Start _________________ Last ________________________
Job Title and Duties _________________________________________________________________________________
Reason for Leaving _________________________________________________________________________________
Previous Company Name _____________________________________ Telephone (_____ ) _____________________
Address ________________________________ City ______________________ State __________ Zip ______________
Employed - (State month and year) From _____________________________ To
________________________________
Name of Supervisor _________________________ Salary Start _________________ Last ________________________
Job Title and Duties _________________________________________________________________________________
Reason for Leaving _________________________________________________________________________________
Previous Company Name _____________________________________ Telephone (_____ ) _____________________
Address ________________________________ City ______________________ State __________ Zip ______________
Employed - (State month and year) From _____________________________ To
________________________________
Name of Supervisor _________________________ Salary Start _________________ Last ________________________
Job Title and Duties _________________________________________________________________________________
Reason for Leaving _________________________________________________________________________________
Previous Company Name _____________________________________ Telephone (_____ ) _____________________
Address ________________________________ City ______________________ State __________ Zip ______________
Employed - (State month and year) From _____________________________ To
________________________________
Name of Supervisor _________________________ Salary Start _________________ Last ________________________
Job Title and Duties _________________________________________________________________________________
Reason for Leaving _________________________________________________________________________________
We may contact the employers listed above unless you indicate those you do not want us to contact.
DO NOT CONTACT Employer _____________________________ Number(s)
__________________________________
Reason ___________________________________________________________________________________________
DO NOT CONTACT Employer _____________________________ Number(s) __________________________________
Reason ___________________________________________________________________________________________
MILITARY
Did you serve in the U.S. Armed Forces? Yes ___ No ___ If yes, what branch? ________________________________
Describe any training received relevant to the position for which you are applying: ____________________________
__________________________________________________________________________________________________
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