Fillable Revised 3/12/10 City of Hendersonville Application for Employment (City of Hendersonville)

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Revised 3/12/10 City of Hendersonville Application for Employment (City of Hendersonville)

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The Revised 3/12/10 City of Hendersonville Application for Employment (City of Hendersonville) form is 5 pages long and contains:

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  • 31 check-boxes
  • 110 other fields

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File type: PDF

U.S.A. forms for City of Hendersonville

BROWSE CITY OF HENDERSONVILLE (NC) FORMS

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Revised 3/12/10
City of Hendersonville 145 Fifth Avenue East, Hendersonville, NC 28792-4328
City of Hendersonville
Application for Employment
We consider applicants for all positions without regard to race, color, religion, creed, gender,
national origin, age, disability, marital status, sexual orientation, or any other legally protected
status. WE ARE AN EQUAL OPPORTUNITY EMPLOYER.
PLEASE PRINT
Position Applied For
Date of Application
How did you learn about us?
Last 4 Digits of Social Security Number
Last Name First Name Middle Name
Mailing Address City State Zip Code
Telephone Number(s)
Work Number
If you are under 18 years of age, can you provide required proof of your eligibility to work? Yes No
Have you ever filed an application with us before?
Yes No
If yes, give date:
Have you ever been employed with us before?
Yes No
If yes, give date:
Are you currently employed? Yes No
May we contact your present employer? Yes No
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?
Proof of citizenship or immigration status will be required upon employment. Yes No
On what day would you be available for work?
Can you travel if a job required it? Yes No
Are you available for work: Full Time Part Time Shift Work Temporary
Have you been convicted of a felony within the last 7 years? Yes No If yes, please explain:
EDUCATION
Name & Address of
School
Course of Study Years Completed Diploma/
Degree
Elementary School
High School
Undergraduate
College
Other (Specify)
Describe any specialized training, apprenticeship, skills, and extra curricular activities-Include Civilian or
Military Training:
EMPLOYMENT EXPERIENCE: Start with your present or last job. Include any job-related
military assignments and volunteer activities. You may exclude organizations that indicate race,
color, religion, gender, national origin, disabilities or other protected status.
Revised 3/12/10
City of Hendersonville 145 Fifth Avenue East, Hendersonville, NC 28792-4328
1.
Employer
Hourly Rate/Salary
Work Performed
Starting
Final
Address
Telephone Number(s)
Dates Employed
From
To
Job Title
Supervisor
Reason for Leaving:
2.
Employer
Hourly Rate/Salary
Work Performed
Starting
Final
Address
Telephone Number(s)
Dates Employed
From
To
Job Title
Supervisor
Reason for Leaving:
3.
Employer
Hourly Rate/Salary
Work Performed
Starting
Final
Address
Telephone Number(s)
Dates Employed
From
To
Job Title
Supervisor
Reason for Leaving:
IF YOU NEED ADDITIONAL SPACE, PLEASE CONTINUE ON A SEPARATE SHEET OF PAPER.
List professional, trade, business or civic activities and offices held. You may exclude membership which
would reveal gender, race, religion, national origin, age, ancestry, disability, or other protected status:
Revised 3/12/10
City of Hendersonville 145 Fifth Avenue East, Hendersonville, NC 28792-4328
ADDITIONAL INFORMATION
OTHER QUALIFICATIONS: Summarize special job-related skills and qualifications acquired from
employment or other experience.
SKILLS: Check the following skills, experiences, etc. which you have.
Drivers License ________________
Number State
Car for use at work
Sign Language
Foreign Language (Specify)
Adding machine/calculator
Typing (specify WPM)
Shorthand/speedwriting
Legal Transcription
Medical Transcription
Braille
Word Processing
Other
______________________
NOTE TO APPLICANT: DO NOT ANSWER THE QUESTIONS UNLESS YOU HAVE BEEN
INFORMED ABOUT THE REQUIREMENTS OF THE JOB FOR WHICH YOU ARE APPLYING.
Are you capable of performing in a reasonable manner, with or without a reasonable accommodation, the
activities involved in the job or occupation for which you have applied? A description of the activities
involved in such a job or occupation is attached. Yes No
REFERENCES
N
ame Address
Phone Number
1.
2.
3.
I understand that falsified statements on this application are justification for refusal or termination of City of
Hendersonville employment. I authorize investigation of my personal history and statements contained in this
application as may be necessary in arriving at an employment decision. IF HIRED, I UNDERSTAND
THAT ON THE FIRST DAY OF EMPLOYMENT I WILL HAVE TO PROVIDE TWO (2) PIECES OF
IDENTIFICATION TO PROVE LEGAL ELIGIBILITY TO WORK IN THE UNITED STATES.
I understand that I am required to abide by all rules and regulations of the employer.
Applicant Signature:________________________________________ Date:______________________________
Office Notes:
Revised 3/12/10
City of Hendersonville 145 Fifth Avenue East, Hendersonville, NC 28792-4328
City of Hendersonville
Human Resources Department
Release of Information Waiver
I, _____________________________, having been selected as an applicant for review
relating to appointment as a City of Hendersonville employee, do waive my right to privacy
relating to any background investigation conducted on behalf of the City of Hendersonville
for the purpose of appointment. I hereby grant the Director of Human Resources or his/her
designee of the City of Hendersonville access to my personnel, financial or any other
pertinent employment or personal information, which, in sole discretion of the City of
Hendersonville may have a bearing on my ability to perform the duties required of a City of
Hendersonville employee. I understand that any person contacted relating to this
subsequent background investigation will be provided with a copy of this waiver and the
original will be available for examination from the Human Resources Department at the
City of Hendersonville City Hall.
Applicant Signature
______________________________
Witness
Special Note: If you are applying for a position with the Hendersonville Police Department
please complete Police Department Application Supplement for your application to be
considered further.
click to sign
signature
click to edit
Revised 3/12/10
City of Hendersonville 145 Fifth Avenue East, Hendersonville, NC 28792-4328
Police Department Application Supplement
1. Please check the position applied for:
Civilian Positions: Sworn Positions:
Telecommunicator Police Officer
Reserve Telecommunicator Reserve Police Officer
Records Clerk
Administrative Assistant
Parking Enforcement
School Crossing Guard
2. Are you a U.S. Citizen? (You must be a U.S. Citizen to work for the Police
Department.) Yes No
3. Have you ever been convicted of a FELONY or a serious MISDEMEANOR? If
yes, explain.
4. If applying for a sworn position:
a. Are you currently North Carolina Basic Law Enforcement Training (BLET)
certified? Yes No
i. If Yes
1. Date certified
2. Name of accredited school
3. What agency, if any, is holding your certification
b. If not certified and you are currently enrolled in BLET, what is your
estimated graduation date?
5. Have you ever used any type of illegal drugs? If yes, list all illegal drugs you have
used and when was the last time you used each drug.
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Revised 31210 City of Hendersonville Application for Employment (City of Hendersonville)

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Completed 3 August 2020

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