Fillable Nelson County Employment Application (Nelson County)

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Nelson County Employment Application (Nelson County)

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The Nelson County Employment Application (Nelson County) form is 4 pages long and contains:

  • 1 signature
  • 4 check-boxes
  • 105 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Nelson County

BROWSE NELSON COUNTY (VA) FORMS

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Nelson County
Employment Application
We consider applicants for all positions without regard to race, color, religion, creed, gender, national
origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. We
are an equal opportunity employer.
Applicant Information
Position Applied For
Date
Last Name
First
M.I
Street Address
Apartment/Unit #
City
Zip
Phone
E-Mail
Are you a citizen of the United State? Yes No If no, are you authorized to work in the U.S.?
Yes No
Have you ever worked for this Yes No If so, When?
organization?
Have you ever been convicted of a felony? Yes No
Desired work?
Full-time
Part-time
Shift
Temporary
On what date would you be available for work?
Can you travel if a job requires it? Yes No
Education
High School
Address
From To
Did you graduate?
Degree
College
Address
From To
Did you graduate?
Degree
Other
Address
From To
Did you graduate?
Degree
Employment Experience
Start with your present or most recent job. Include any job-related military service
assignments. You may exclude organizations which indicate race, color, religion, gender,
national origin, disabilities or other protected status.
Company
Phone ( )
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From To
Reason For Leaving
May we contact your previous supervisor for a reference? Yes No
Company
Phone ( )
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From To
Reason For Leaving
May we contact your previous supervisor for a reference? Yes No
Company
Phone ( )
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
From To
Reason For Leaving
May we contact your previous supervisor for a reference? Yes No
Military Service
Branch
From To
Rank at Discharge
Type of Discharge
If other than honorable, explain
Specialized Skills
Language Skills: Spoken Written
Trades/Maintenance Skills
Technical Skills
Use this space for any additional information you think would help us evaluate your
application, including training, seminars, workshops, software programs, and specialized
skills.
List professional, trade, business, volunteers experience or civic activities.
References
Please list three professional references
Full Name
Relationship
Company
Phone ( )
Address
Full Name
Relationship
Company
Phone ( )
Address
Full Name
Relationship
Company
Phone ( )
Address
APPLICANT’S STATEMENT
I certify that answers given herein are true and complete to the best of my knowledge. I
authorize investigation of all statements contained in this application for employment a
may be necessary in arriving at an employment decision. This application for
employment shall be considered active for a period of time not to exceed 60 days. Any
applicant wishing to be considered for employment beyond this time period should
inquire as to whether or not applications are being accepted at that time. I hereby
understand and acknowledge that, unless otherwise defined by applicable law, any
employment relationship with this organization is of an “at will “ nature, which means
that the Employee may resign at any time and the Employer may discharge Employee at
any time with or without cause. It is further understood that this “at will” employment
relationship may not be changed by any written document or by conduct unless such
change is specifically acknowledged in writing by an authorized executive of this
organization. In the event of employment, I understand that false or misleading
information given in my application or interview(s) may result in discharge. I understand,
also, that I am required to abide by all rules and regulations of the employer.
___________________________________________________________________
Signature of Applicant Date
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Nelson County Employment Application (Nelson County)

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Completed 6 August 2020

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