Fillable GENERAL EMPLOYMENT APPLICATION (City of Portage)

Fill Online, Printable, Fillable, Blank GENERAL EMPLOYMENT APPLICATION (City of Portage) Form

Use Fill to complete blank online CITY OF PORTAGE (WI) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

GENERAL EMPLOYMENT APPLICATION (City of Portage)

On average this form takes 36 minutes to complete

The GENERAL EMPLOYMENT APPLICATION (City of Portage) form is 3 pages long and contains:

  • 1 signature
  • 20 check-boxes
  • 130 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Portage

BROWSE CITY OF PORTAGE (WI) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
GENERAL EMPLOYMENT APPLICATION
City of Portage
115 W Pleasant St., Portage, WI 53901
608-742-2176
DATE OF APPLICATION__________________________
PLEASE TYPE OR PRINT LEGIBLY IN INK – IF MORE SPACE IS NEEDED ATTACH ADDITIONAL PAPER
PERSONAL DATA
NAME: (LAST)
(FIRST)
(MIDDLE)
TELEPHONE
( )
EMAIL
ADDRESS: (STREET)
(CITY)
(ZIP CODE)
EMPLOYMENT DESIRED
POSITION
DATE YOU CAN START
SALARY DESIRED
ARE YOU EMPLOYED NOW?
Yes No
REFERRED BY:
OTHER EMPLOYMENT – RELATED INFORMATION
CHECK THE FOLLOWING OPTIONS WHICH YOU
WOULD CONSIDER
FULL-TIME PART-TIME TEMPORARY
LIST ANY RELATIVES WORKING FOR CITY OF PORTAGE?
NAME: DEPARTMENT:
CAN YOU VERIFY THAT YOU ARE AT LEAST 18
YEARS OF AGE?
YES NO
IF YOU WERE YOU PREVIOUSLY EMPLOYED, BY THE CITY OF PORTAGE, LIST
DATES AND JOB TITLES:
DATE: JOB TITLE:
DATE: JOB TITLE:
ARE YOU A UNITED STATES CITIZEN OR A
PERMANENT RESIDENT ALIEN?
YES NO
IF NOT A U.S. CITIZEN, CAN YOU AFTER
EMPLOYMENT OFFER IS EXTENDED, SUBMIT
VERIFICATION OF YOUR LEGAL RIGHT TO WORK
PERMANENTLY IN THE U.S.?
YES NO
HAVE YOU EVER BEEN CONVICTED OF A FELONY, OR PLEADED NO CONTEST IN A
FELONY, OR BEEN CONVICTED OF A MISDEMEANOR RESULTING IN IMPRISONMENT
OR A FINE OF $500 OR MORE? (CONVICTION WILL NOT NECESSARILY DISQUALIFY
AN APPLICANT)
YES NO
ARE YOU SUBJECT TO ANY PENDING CRIMINAL CHARGES?
YES NO
IF YES TO EITHER, EXPLAIN:
UPON REVIEWING THE JOB REQUIREMENTS,
ARE THERE ANY PHYSICAL LIMITATIONS YOU
HAVE THAT MIGHT CAUSE DIFFICULTY IN YOUR
ABILITY TO PERFORM THE JOB BEING APPLIED
FOR?
YES NO
IF YES, PLEASE EXPLAIN THE TYPE OF
ACCOMMODATION REQUIRED:
NAME AND TELEPHONE NUMBER (WITH AREA CODE) OF THE PERSON TO CONTACT
IN CASE OF AN EMERGENCY:
NAME:
ADDRESS:
PHONE:
( )
CITY OF PORTAGE IS AN EQUAL OPPORTUNITY EMPLOYER, IT IS OUR
POLICY TO ABIDE BY ALL FEDERAL AND STATE LAWS PROHIBITING
EMPLOYMENT DISCRIMINATION SOLELY ON THE BASIS OF A
PERSON’S RACE, CREED, COLOR, NATIONAL ORIGIN, RELIGION, AGE
(OVER 40), SEX, MARITAL STATUS, OR PHYSICAL HANDICAP, EXCEPT
WHERE A REASONABLE, BONA-FIDE OCCUPATIONAL QUALIFICATION
EXISTS.
Rev. 9/14/2017
1
EXPERIENCE
IF AVAILABLE – PLEASE ATTACH YOUR RESUME TO THIS APPLICATION
LIST THE LAST TEN (10) YEARS WORK EXPERIENCE BEGINNING WITH THE MOST RECENT – BE SURE TO EXPLAIN GAPS IN EMPLOYMENT
NAME OF EMPLOYER:
TYPE OF BUSINESS:
ADDRESS: (STREET)
(CITY)
(STATE)
(ZIP CODE)
PHONE NUMBER
PERIOD OF EMPLOYMENT:
STARTING JOB TITLE:
FROM TO ENDING JOB TITLE:
EMPLOYMENT STATUS:
FULL-TIME
PART-TIME
TEMPORARY
NAME AND TITLE OF SUPERVISOR:
BRIEF DESCRIPTION OF DUTIES:
MAY WE CONTACT? YES NO
REASON FOR LEAVING:
PRESENT SALARY:
NAME OF EMPLOYER:
TYPE OF BUSINESS:
ADDRESS: (STREET)
(CITY)
(STATE)
(ZIP CODE)
PHONE NUMBER
PERIOD OF EMPLOYMENT:
STARTING JOB TITLE:
FROM TO
ENDING JOB TITLE:
EMPLOYMENT STATUS:
FULL-TIME PART-TIME TEMPORARY
NAME AND TITLE OF SUPERVISOR:
BRIEF DESCRIPTION OF DUTIES:
MAY WE CONTACT? YES NO
REASON FOR LEAVING:
LAST SALARY:
NAME OF EMPLOYER:
TYPE OF BUSINESS:
ADDRESS: (STREET)
(CITY)
(STATE)
(ZIP CODE)
PHONE NUMBER
PERIOD OF EMPLOYMENT:
STARTING JOB TITLE:
FROM TO
ENDING JOB TITLE:
EMPLOYMENT STATUS:
FULL-TIME PART-TIME TEMPORARY
NAME AND TITLE OF SUPERVISOR:
BRIEF DESCRIPTION OF DUTIES:
MAY WE CONTACT?
YES
NO
REASON FOR LEAVING:
LAST SALARY:
COMMENTS
DRIVERS LICENSE
LIST ANY COMMENTS, SPECIAL SKILLS, OR QUALIFYING
STATEMENTS YOU CARE TO MAKE:
DO YOU HAVE A VALID WISCONSIN DRIVERS LICENSE?
YES NO
DO YOU HAVE A VALID CDL?
YES
NO
IF YES, WHAT ENDORSEMENTS?
Rev. 9/14/2017
2
EDUCATION AND TRAINING
HIGH SCHOOL
COMPLETE ADDRESS GRADUATED/GED?
YES NO
COLLEGE OR UNIVERSITY
COMPLETE ADDRESS MAJOR/DEGREE
GRADUATE SCHOOL
COMPLETE ADDRESS
MAJOR/DEGREE
TRADE/TECH SCHOOL
COMPLETE ADDRESS
MAJOR/DEGREE
U.S. MILITARY SERVICE
RANK
PRESENT MEMBER OF NAT'L GUARD OR RESERVES?
YES NO
PLEASE LIST: ANY OTHER CERTIFICATIONS OR LICENSES, YOU HOLD; ANY MACHINES OR EQUIPMENT YOU ARE QUALIFIED TO
OPERATE; AND ANY LANGUAGES YOU SPEAK FLUENTLY (INCLUDING SIGN LANGUAGE)
REFERENCES
LIST ANY BUSINESS PERSONS KNOWN TO YOU FOR AT LEAST THREE (3) YEARS – NOT RELATED
NAME/TITLE
1.
BUSINESS NAME AND ADDRESS
YEARS KNOWN
PHONE NUMBER
2.
3.
APPLICANT’S CERTIFICATION
PLEASE READ CAREFULLY BEFORE SIGNING. IF YOU HAVE ANY QUESTIONS REGARDING THE FOLLOWING STATEMENTS, PLEASE ASK.
1. I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE ANSWERS GIVEN BY ME IN THE FORGOING QUESTIONS AND
THE STATEMENTS ARE CORRECT AND COMPLETE. I UNDERSTAND THAT ANY OMISSIONS, MISLEADING OR FALSE INFORMATION
CONTAINED IN THIS APPLICATION MAY RESULT IN MY IMMEDIATE DISCHARGE. I AGREE THAT THE CITY OF PORTAGE SHALL NOT
BE HELD LIABLE IN ANY RESPECT IF MY EMPLOYMENT IS TERMINATED BECAUSE OF FALSE STATEMENT, ANSWERS OR OMISSIONS
MADE BY ME IN THIS APPLICATION.
2. I ALSO AUTHORIZE PERTINENT COMPANIES, SCHOOLS, AGENCIES, POLICE DEPARTMENTS OR PERSONS TO GIVE ANY
INFORMATION REQUESTED REGARDING MY EMPLOYMENT, CHARACTER, EXPERIENCE, QUALIFICATIONS AND/OR SUITABILITY FOR
EMPLOYMENT. I HEREBY FOREVER RELEASE, DISCHARGE AND COVENANT NOT TO SUE ANY PERSON OR ORGANIZATION FOR ANY
RESULT OF PROVIDING, OBTAINING OR ACTING UPON SUCH INFORMATION. I UNDERSTAND THAT SUCH INFORMATION IS SOUGHT
WITH CONFIDENTIALITY AND I WILL NOT REQUEST COPIES OF SUCH INFORMATION. IN ADDITION, A COPY OF THIS AUTHORIZATION
IS AS VALID AS THE ORIGINAL AND SHOULD BE RECOGNIZED AS SUCH.
3. I UNDERSTAND THAT ANY OFFER OF EMPLOYMENT OR CONTINUED EMPLOYMENT, IF HIRED, MAY BE CONDITIONED UPON PASSING
A PHYSICAL EXAMINATION, INCLUDING SUBSTANCE ABUSE SCREENING. REFUSAL TO PARTICIPATE WILL RESULT IN TERMINATION
OR DENIAL OF EMPLOYMENT.
4.
I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY BE TERMINATED AT ANY TIME
WITHOUT ANY PRIOR NOTICE.
DATE:_____________________________
SIGNATURE:________________________________________________________
THIS APPLICATION IS CURRENT FOR 6 MONTHS. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.
Rev. 9/14/2017
3
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

GENERAL EMPLOYMENT APPLICATION (City of Portage)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 19 June 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document