Fillable Iowa Judicial Branch Application for Employment (Iowa Judicial Branch)

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Iowa Judicial Branch Application for Employment (Iowa Judicial Branch)

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The Iowa Judicial Branch Application for Employment (Iowa Judicial Branch) form is 7 pages long and contains:

  • 0 signatures
  • 24 check-boxes
  • 96 other fields

Country of origin: US
File type: PDF

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1
Iowa Judicial Branch
Application for Employment
Please route to:
GENERAL INFORMATION
Complete this application in detail. Print or type your responses.
Resumes may be added but cannot be substituted for a fully completed application.
Filing an application does not imply that you will be interviewed or hired. It only provides that your
qualifications will be considered for vacancies indicated.
Although you are not required to provide your social security number on this application, you may be
asked to provide it at a later point In order to be considered further in the hiring process.
All persons hired by the Iowa Judicial Branch must complete an Immigration and Naturalization Service
Form I-9 and provide proof of their identity and eligibility to work in the United States.
The Iowa Judicial Branch does not allow employees to directly supervise a spouse, a relative or a
relative of a spouse within the 1
st
- 3
rd
degree of consanguinity; employment of relatives within the
1
st
- 3
rd
degree of consanguinity under the same supervisor is discouraged.
The Iowa Judicial Branch is an Equal Employment Opportunity Employer. Qualified applicants are
eligible to compete for all positions without regard to race, color, national origin, sex, gender preference,
gender identity, creed, religion, age, disability or marital status.
All Iowa Judicial Branch work locations are smoke-free as required by Iowa law.
2
APPLICANT INFORMATION
Date of Application
Position for which you are applying
Last Name, First Name, Middle Initial
Street Address, City, State Zip Code
(Area Code) Phone Number – Days (Area Code) Phone Number - Evenings
List all previous names or aliases you have used:
E-mail address:
How did you know this position was available: (ex. Iowacourts.gov website, State of Iowa website,
newspaper, job board, association, etc.?):
Are you legally eligible to work in the United States? yes no
(Proof of identity and eligibility will be required upon employment)
If the address above is not in Iowa, do you maintain a residence in Iowa? yes no
If yes, what is the address of your Iowa residence:
List all relatives who currently work for the Iowa Judicial Branch and their relationship to you:
3
Last Name, First Name, Middle Initial
EXPERIENCE RECORD
List your work experience, starting with the most recent. If you have held more than one job with
the same organization, list them separately.
Describe your experience in sufficient detail, so that we can fairly assess your level of
responsibility. Include the number and titles of people supervised and systems, programs,
equipment or facilities managed/used.
Current Position
Organization, Your Title
Address, City, State, Zip Code
Supervisor’s Name and Phone Number
Is this a supervisory position? yes no
If yes, what is the number of direct reports Indirect reports?
Duties:
From:
To:
Salary (Beginning/Ending)
Reason for leaving or
considering leaving:
Previous Position
Organization, Your Title
Address, City, State, Zip Code
Supervisor’s Name and Phone Number
Is this a supervisory position? yes no
If yes, what is the number of direct reports Indirect reports?
Duties:
From:
To:
Salary (Beginning/Ending)
Reason for leaving or
considering leaving:
4
Last Name, First Name, Middle Initial
Previous Position
Organization, Your Title
Address, City, State, Zip Code
Supervisor’s Name and Phone Number
Is this a supervisory position? yes no
If yes, what is the number of direct reports Indirect reports?
Duties:
From:
To:
Salary (Beginning/Ending)
Reason for leaving or
considering leaving:
Previous Position
Organization, Your Title
Address, City, State, Zip Code
Supervisor’s Name and Phone Number
Is this a supervisory position? yes no
If yes, what is the number of direct reports Indirect reports?
Duties:
From:
To:
Salary (Beginning/Ending)
Reason for leaving or
considering leaving:
If you have additional previous positions you would like considered, copy and attach additional pages.
5
Last Name, First Name, Middle Initial
AVAILABILITY
When are you available for interviews:
What is your minimum salary requirement? per
When are you available to start new employment?
CHECK ALL BOXES THAT APPLY:
Full-time job (40 hours per week)
Part-time job (Less than 40 hours per week)
Travel (Open to a position that may require overnight and/or daytime travel)
No Travel (Open to a position that does not require any travel)
EDUCATION RECORD
Name and
Location
Course of
Study
Number.
of Years
Attended
Diploma or
Degree Earned
High School/G.E.D.
Trade/Business
School
College/University
College/University
(Graduate Work)
Other Training or
Degrees
If you are working towards a degree, please give anticipated completion date and type of degree:
6
Last Name, First Name, Middle Initial
SPECIAL SKILLS
List any professional licenses you hold:
List any professional memberships you hold:
(You need not disclose any membership that may reveal information regarding race, color, creed, sex,
religion, national origin, ancestry, age, disability, marital status, veteran status, or any other protected status.)
List computer software with which you are proficient:
List languages, other than English, that you speak, read and write fluently:
Typing Speed: wpm
List special equipment or office machines you can operate:
If applying for a position that requires driving, do you have a valid driver’s license? yes no
If yes, please give the license number:
VETERANS STATUS
To be considered for veteran’s preference in employment over other applicants of no greater
qualifications, you must submit proof of service and honorable discharge from the military or naval
forces of the United States during any war or conflict for which a campaign badge or service medal
has been authorized. Acceptable proof is a certified photocopy of a DD-214 which becomes the
property of the Iowa Judicial Branch and will not be returned.
ADDITIONAL INFORMATION
Have you ever received a disciplinary suspension, been asked to resign, or discharged from a job?
yes no
If yes, please explain:
Explain any gaps in work history:
Have you ever worked for the Iowa Judicial Branch before? yes no
If yes, when? from to Location:
Name of Supervisor:
Reason for leaving:
Are you able to perform the essential functions of this job with or without a reasonable accommodation?
yes no
7
REVIEW BEFORE SIGNING
I CERTIFY that the information I have given is complete, true, and correct to the best of my
knowledge. I further affirm that I have not knowingly withheld any facts or circumstances in
completing this application.
I UNDERSTAND that any incorrect, incomplete or false statements or information furnished by
me may void this application, remove me from consideration for employment, disqualify me from
applying for any other position with the Iowa Judicial Branch and subject me to discipline up to
and including discharge.
I understand that information on this application and any documents submitted to the Iowa
Judicial Branch as part of the application process may, in compliance with Iowa Code Chapter
22, become public record and may be made available to the public upon request. Only
information deemed confidential in accordance with applicable statutes may be withheld from
public disclosure.
I understand that this application is not a guarantee of employment. I also understand that if
offered a position with the Judicial Branch, I may be required to submit to a background check as
a condition of employment. I understand that unsatisfactory results or refusal to cooperate with
this pre-employment check will result in withdrawal of any employment offer or termination of
employment if already employed.
I understand that the Immigration and Control Act of 1986 (Public Law #99-603) requires that all
new employees must provide documents proving their U. S. citizenship or their authorized alien
work status to begin employment. I further understand that all job offers are conditional on the
production of satisfactory documentation, as required by this law.
Authorization and Release
I AUTHORIZE the Iowa Judicial Branch to contact my current and former employers and to
conduct any reasonable inquiry that may be necessary to verify the information I have provided
on this form or may provide in conjunction with seeking employment. I hereby authorize any
current and former employers to verify information I have provided and to discuss any work-
related information concerning me, including, but not limited to, my position, job duties, salary,
job performance, attendance history, disciplinary record and the circumstances surrounding my
departure. I further unqualifiedly release those supplying such information from any and all
claims or liability associated with such discussion or disclosure as provided in Iowa Code Section
91B.2.
If you submit your application electronically, your printed name or a digitized signature placed in
the signature line acts as a valid signature.
Signature of Applicant Date
REV 6.19.19
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Iowa Judicial Branch Application for Employment (Iowa Judicial Branch)

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Completed 20 July 2020

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