Fillable Form 1300: Employment Application (City of Duvall)

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Form 1300: Employment Application (City of Duvall)

On average this form takes 30 minutes to complete

The Form 1300: Employment Application (City of Duvall) form is 3 pages long and contains:

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

Country of origin: US
File type: PDF

U.S.A. forms for City of Duvall

BROWSE CITY OF DUVALL (WA) FORMS

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CONTINUED ON NEXT PAGE
- 1 -
REVISION 06/2019
Position Title:
Referral Source: Advertisement Friend Relative Walk-In
Date of Application:
Employment Agency Other
Name:
LAST FIRST
MIDDLE INITIAL
Address:
NUMBER STREET CITY STATE ZIP CODE
Phone: ____________________________________________ Email: _________________________________________________________
Have you filed an application here before? YES NO If yes, Give date
Have you been employed here before? YES NO If yes, Give date From To
On what date would you be available for work?
Are you employed now? YES NO If yes, may we contact your present employer? YES NO
Are you on a lay-off and subject to recall? YES NO
Are you available to work Part Time Full Time Shift Work Temporary
Are you over the age of 18? YES NO
Are you a U.S. citizen, or do you have a Visa permitting you to work in the U.S.? YES NO
(Documentation of authorization to work in the U.S. will be required if an offer of employment is made and accepted.)
Can you travel if the job requires it? YES NO
If you are applying for a position where you will be expected to drive on duty, do you have or can you obtain, a valid
Washington State Driver’s License? YES NO N/A
Do you wish to claim Veteran’s Preference for testing, pursuant to RCW 41.04.010? YES NO
Employment Application
City of Duvall
P.O. Box 1300
15535 Main Street NE
Duvall, WA 98019
-
1300
(425) 788-1185
Fax (425) 788-8097
job.apply@duvallwa.gov
www.duvallwa.gov
The City of Duvall is an equal opportunity employer and does not unlawfully discriminate on the basis of race and
color, religion and creed, national origin, sex, marital status, HIV, AIDS, and hepatitis C status, honorably discharged
veteran or military status, age, disability, pregnancy and maternity, sexual orientation and gender identity, use of a
guide dog or other service animal, genetic information or any other protected class status. Equal access to programs,
services and employment is available to all persons. Those applicants requiring reasonable accommodations to the
application and/or interview process shall notify the City Clerk.
READ ALL INSTRUCTIONS BEFORE COMPLETING APPLICATION
1. MUST BE LEGIBLE
2. YOU MUST SHOW THAT YOU MEET THE ANNOUNCED MINIMUM REQUIREMENTS
3. YOU MUST SUBMIT AN APPLICATION FOR EACH POSITION
4. RESUMES MAY BE ATTACHED BUT WILL NOT BE ACCEPTED AS A SUBSTITUTE
Please Print or Type
CONTINUED ON NEXT PAGE
- 2 -
REVISION 06/2019
Employment History
Start with your present or last job. Include military service assignments and volunteer activities.
Complete the following sections even if you are submitting a resume. Attach additional sheets as necessary.
To
From
Supervisor
Hours Worked Per Week
Number of Employees Supervised By You
Employer’s Name
Address
Phone
Position
Reason For Leaving
Primary Duties
To
From
Supervisor
Hours Worked Per Week
Number of Employees Supervised By You
Employer’s Name
Address
Phone
Position
Reason For Leaving
Primary Duties
To
From
Supervisor
Hours Worked Per Week
Number of Employees Supervised By You
Employer’s Name
Address
Phone
Position
Reason For Leaving
Primary Duties
To
From
Supervisor
Hours Worked Per Week
Number of Employees Supervised By You
Employer’s Name
Address
Phone
Position
Reason For Leaving
Primary Duties
- 3 -
REVISION 06/2019
Education and Training
Highest Grade Completed: 8 9 10 11 12 GED
Colleges/Other Training
Major/Subject
Degree/Certificate
Date Completed
Foreign Languages _
SPEAK READ WRITE
List any Extracurricular Activities, Honors Received, or any additional information you feel may be helpful to us in considering your
application.
References
LIST TWO PROFESSIONAL REFERENCES
1.
NAME RELATIONSHIP YEARS KNOWN TELEPHONE NUMBER
2.
NAME RELATIONSHIP YEARS KNOWN TELEPHONE NUMBER
The City of Duvall is mindful of its obligation to employ qualified person and its entitlement under law to consider an applicant’s
conviction(s) record as it relates to job performance. A conviction record will not automatically disqualify you for employment. Applicants
will be asked to disclose information about their criminal history in the last ten years.
To the best of my knowledge, the information herein is true and complete. I have read the Position Opening Announcement
and I can perform the essential functions of the position for which I am applying, with or without reasonable accommodation.
I understand that if I am applying for employment in a position where I will or may have unsupervised access to children,
developmentally disabled persons, or vulnerable adults, the City of Duvall will complete a thorough background check as
allowed by the Child/Adult Abuse Information Act. Background checks are also completed for other positions. I understand
that I will be tested for the presence of drugs as part of the pre-employment screening if I am applying for a safety sensitive
position or one which requires a Commercial Driver License. I authorize investigation of all statements in this application. I
understand that providing false information on this application is grounds for disqualification and/or dismissal. I understand
that nothing in this application or my communications with any City of Duvall official is intended to create an employment
contract between the City of Duvall and me.
SIGNATURE DATE
LIST TWO PERSONAL REFERENCES
1.
NAME RELATIONSHIP YEARS KNOWN TELEPHONE NUMBER
2.
NAME RELATIONSHIP YEARS KNOWN TELEPHONE NUMBER
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Form 1300: Employment Application (City of Duvall)

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Completed 13 November 2021

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