Fillable Hall County Equal Employment Opportunity Employer Application for (Hall County)

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Hall County Equal Employment Opportunity Employer Application for (Hall County)

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The Hall County Equal Employment Opportunity Employer Application for (Hall County) form is 4 pages long and contains:

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  • 37 check-boxes
  • 75 other fields

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File type: PDF

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Hall County
Equal Employment Opportunity Employer
Application for Employment
This application is good until the position is filled.
Hall County assures equal employment opportunity to applicants and employees in all aspects of personnel administration
without regard to political affiliation, race, color, national origin, sex, age, marital status, pregnancy, mental or physical
disability, genetic information, religion, military status, or any other prohibited basis of discrimination, as provided under
applicable state and federal law.
FEDERAL LAW OBLIGATES US TO PROVIDE REASONABLE ACCOMMODATION TO THE KNOWN
DISABILITIES OF APPLICANTS AND EMPLOYEES, UNLESS TO DO SO WOULD POSE AN UNDUE HARDSHIP.
PLEASE FEEL FREE TO LET US KNOW IF YOU NEED AN ACCOMMODATION TO COMPLETE THE
APPLICATION PROCESS OR TO PERFORM ANY ESSENTIAL ELEMENTS OF THE POSITION SOUGHT.
Type of Work Desired (CHECK ALL THAT APPLY):
Full-Time Part-Time Regular Temporary
Have you ever been employed here before? Yes No If yes, give date: __________________________________________________
Have you filed an application here before? Yes No If yes, give date: __________________________________________________
Applicant's Name (Last, First, Middle Initial): _____________________________________________________________________________
Street Address: ______________________________________________________________________________________________________
City, State, Zip Code: ________________________________________________________________________________________________
Home Telephone Number: ______________________________ Work Telephone Number: ________________________________________
Position Applied For: _________________________________ Date Available for Work ________________________________________
How did you learn about the job you have applied for? (Be specific as to the
source.)_______________________________________________
Are you legally authorized to work in the United States? Yes No
If hired, you will be required to submit documents sufficient to establish employment authorization and identity in compliance
with the Immigration Reform and Control Act of 1986. While you need not provide this proof of citizenship or immigration
status at the time you are interviewed, please be prepared to assure us that you can do so immediately upon being hired if you
receive an offer of employment.
This position is subject to a veterans preference. Are you eligible for and requesting a veterans preference? Yes
(A veteran requesting preference must submit with his/her Application for Employment a copy of the veteran’s Department of
Defense Form 214. A spouse of a veteran requesting preference must submit with his/her Application for employment a copy of
the veteran’s Department of Defense Form 214, a copy of the veteran’s disability verification from the United States Department
of Veteran Affairs demonstrating a 100 percent permanent disability rating, and proof of marriage to the veteran.)
EMPLOYMENT RECORD
List below the positions you have held, starting with your present employment. If more than one position or classification has
been held with a given organization, list each position or classification as a separate period of employment. Under "Specific
Duties," describe clearly the tasks you performed and the nature of your supervisory, technical, or other responsibilities. Please
be complete. Your employment history may be verified by contacting previous employers. Volunteer, military, or unpaid
experience will be evaluated in the same manner as paid employment and should be entered in the same manner. If you need
more space, attach a separate sheet of paper. Please exclude organization names that indicate, for example, race, color, religion,
sex, disability, or national origin.
Employment Information
Description of Duties
Employer/Kind of Business
Position Title
Street Address
Specific Duties
Immediate Supervisor/Title
Telephone Number
Dates of Employment (Month/Year)
From: To:
Hourly Rate/Salary
Starting: Final:
Part-Time Full-Time
Reason for Leaving
Employment Information
Description of Duties
Employer/Kind of Business
Position Title
Street Address
Specific Duties
Immediate Supervisor/Title
Telephone Number
Dates of Employment (Month/Year)
From: To:
Hourly Rate/Salary
Starting: Final:
Part-Time Full-Time
Reason for Leaving
Employment Information
Description of Duties
Employer/Kind of Business
Position Title
Street Address
Specific Duties
Immediate Supervisor/Title
Telephone Number
Dates of Employment (Month/Year)
From: To:
Hourly Rate/Salary
Starting: Final:
Part-Time Full-Time
Reason for Leaving
Employment Information
Description of Duties
Employer/Kind of Business
Position Title
Street Address
Specific Duties
Immediate Supervisor/Title
Telephone Number
Dates of Employment (Month/Year)
From: To:
Hourly Rate/Salary
Starting: Final:
Part-Time Full-Time
Reason for Leaving
EDUCATION/SKILLS RECORD
Please list education or specialized experience that relates to the position(s) for which you are applying. Exclude names or terms
that indicate, for example, race, color, religion, sex, disability, or national origin.
Circle Highest Grade Completed: 6 7 8 9 10 11 12
College: 1 2 3 4 5 ___ Did You Graduate? ___Yes
____No
Post- High School
Name of School
To
Major
Degree Type
College/University
Graduate School
If required by the job you have applied for, have you had training/course work or experience in (please check those that apply):
Typing
Word Processing
Data Entry
PC/Computer Terminal
Calculator/Adding
Machine
Dictation Equipment
Shorthand/Speedwriting
Please list any other types of equipment you can operate or skills you possess, which you feel would be an asset in the position
for which you are applying: ____________________________________________________________________________________________
__________________________________________________________________________________________________________________
LICENSES AND CERTIFICATES
If a license, certificate, or other authorization to practice a trade or profession is required for the position for which you are
applying, complete the following questions:
Name of Trade or Profession
License Number
Granted by
City and/or State
Specialty
Licensed From: To:
APPLICANT'S STATEMENT
These answers are true and complete to the best of my knowledge. I understand that any false, omitted, or misleading
information in connection with this application or during the interview process will result in rejection of my application or
termination of my employment if I am hired, regardless of when discovered.
I also understand that any offer of employment may be conditioned upon a health evaluation by a doctor selected by the County
to determine whether I can perform the job duties. In addition, I understand a drug or alcohol test may be required, depending
upon County policy. I authorize the County to make a thorough investigation of my past employment, education, criminal
history, job-related activities, and other relevant background information, and I release from all liability all persons, companies,
and corporations providing such information, either in writing or orally. I also indemnify this County against any liability that
might result from making such investigation.
Additionally, I authorize the County to supply my employment record, in its sole discretion, in whole or in part, to any
prospective employer, government agency, or other party with an interest that the County deems appropriate.
Additionally, I understand that nothing contained in this employment application or in the granting of an interview is
intended to create a contract between Hall County and myself for either employment or for the providing of any benefit
arising from employment. No promises regarding employment have been made to me. I understand that if an
employment relationship is established, I have the right to terminate my employment at any time and Hall County retains
the same right, regardless of any oral representations to the contrary. Any changes in this “at will” employment
relationship must be made in writing and approved by the County Board.
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HERE
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Date
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Hall County Equal Employment Opportunity Employer Application for (Hall County)

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Completed 19 January 2021

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