Personnel Department - City of Bisbee
76 Erie Street PO Box 4601
Bisbee, Arizona 85603
Tx: (520) 432-6271 Fx: (520) 432-6069
VOLUNTEER APPLICATION
Instructions:
You may apply by mailing or delivering a completed application form to:
Drop Off: Mail:
City of Bisbee City of Bisbee
76 Erie Street PO Box 4601
Bisbee, AZ 85603 Bisbee, AZ 85603
Applications can also be emailed to personnel@bisbeeaz.com or faxed to (520) 432-6069.
Volunteer Applications which are incomplete or unsigned will not be accepted.
The city accepts and encourages the involvement of volunteers in various City departments. A volunteer is anyone who, without
compensation or expectation of compensation, performs a task at the direction of and on behalf of the City. Volunteers must be
officially accepted and enrolled by the City as provided in this policy prior to the performance of any tasks. The City accepts
the service of each volunteer at its sole discretion. Either the City or the volunteer may terminate the relationship at any time,
and for whatever reason. Volunteer in some departments or positions may require a background check.
The City of Bisbee provides an equal employment opportunity (EEO) for all persons regardless of race, color, sex age, religion,
national origin, disability, or marital status. The City of Bisbee complies with applicable state and local laws governing
nondiscrimination in all employment activities.The City of Bisbee complies with the American’s with Disabilities Act (ADA)
and will provide reasonable accommodation for qualified individuals with disabilities. Requests for reasonable accommodation
during the recruitment or hiring process must be sent to the Personnel Department.
Last Name First Name Middle Initial
Mailing Address City State Zip Code
Telephone Number Email Date Of Birth Social Security Number
Volunteer Position/Department Requested: Date of Application:
__________________________________________________________________________________________________________
How did you learn about us?
City website City Employee Newspapter Ad Online Ad Other :
City of Bisbee
Volunteer Application
Education High School, College, University, Technical/Trade School or any other educational programs
School Name
Location: City / State
Course of Study
Years completed
Employer: Job Title: _________________________________
Employer Address: __________________________________________________________________________________________
Telephone: ( ) May we contact this employer? Yes No
From: / to /
month year month year
Reason for Leaving: Name of Supervisor: _______________________
Description of Duties: __________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Employer: Job Title: _________________________________
Employer Address: __________________________________________________________________________________________
Telephone: ( ) May we contact this employer? Yes No
From: / to / Total months: Hours/ week:
month year month year
Reason for Leaving: Name of Supervisor: _______________________
Description of Duties: __________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
EMPLOYMENT HISTORY: Please provide an accurate and complete description of any work which qualifies you for the
volunteer opportunity for which you are applying. Include service in the armed forces or self-employment. Start with your
present or most recent employer. If you have more jobs to list than space allows, continue on the Employment History
Continuation Sheet.
City of Bisbee
Volunteer Application
Employer: Job Title: _________________________________
Employer Address: __________________________________________________________________________________________
Telephone: ( ) May we contact this employer? Yes No
From: / to / Total months: Hours/ week:
month year month year
Reason for Leaving: Name of Supervisor: _______________________
Description of Duties: __________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Skills/Training: Describe any specialized training, licenses, certifications, language proficiencies or other qualifications which
have not been previously listed and which you believe relate to the position for which you are applying. Be specific in your description:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
References: List three professional references with direct knowledge of your work experience.
Name
Phone Number
Email
Occupation
EMPLOYMENT HISTORY - CONTINUED
I hereby certify and affirm that all the information contained in this application and all supplemental attachments is true,
complete and correct. I understand that false or misleading statements or the omission of important information made on
this application or any time during the selection process may disqualify me from volunteer opportunites or subject me to
immediate dismissal if already enrolled as a volunteer.
Volunteer Signature: Date:
If volunteer is under 18,
Parent/Guardian SIGNATURE: Date:
Parent/Guardian Name PRINTED:
City of Bisbee
Volunteer Application
Employment Application Addendum
Please complete the following and return this form with your completed application for employment.
Both application and addendum must be signed.
1. Do you have any criminal convictions (not to include civil traffic violations and juvenile offenses)?
If so, give the details below, including when and where the offense occurred and the disposition
of the case. For MOST jobs, convictions will NOT automatically be grounds for disqualification
from consideration. The failure to answer truthfully will be grounds for disqualification.
Yes ______ No ______
Details:
2. Are you currently subject to any probation or parole orders or any civil orders that restrict or
regulate your conduct in any manner? If so, please explain fully.
Yes ______ No ______
Details:
I hereby certify that all statements contained herein are true to the best of my knowledge and I understand
omissions or misstatements may be cause for rejection of this application, removal of my name from an
eligibility list or discharge from the City of Bisbee, regardless of the time of discovery.
Signature: _________________________________________ Date: __________________
Name printed:
City of Bisbee
Volunteer Application
Authorization and Consent To Disclosure
Date ___________________ (Expires six months from this date unless revoked earlier.)
I understand that all information provided to the City of Bisbee is subject to verification. To assist the City of
Bisbee in processing my employment application, the undersigned applicant for employment hereby authorizes
any employer or prior employer, educational institution, law enforcement agency, consumer reporting agency,
governmental agency, or any person or organization possessing employment, educational or police record
information concerning me to release all such information to the City of Bisbee, its agents and employees.
Name:
Date of Birth: SS#:
Maiden Name:
Other Name(s) Used:
Driver’s License #: State:
I specifically authorize the City of Bisbee, through its designated representatives, to view, copy, be furnished
copies and be given details of all such employment information, educational records, police records and
financial information, specifically to include credit history information. Any copy of this authorization shall
have the same authority as the original.
Signature _________________________________________________________________________
Physical Address
City of Bisbee
Volunteer Application
Employment Application Addendum
For positions within the Police Department, Fire Department
and certain Public Works and other department positions.
In accordance with the Drug-Free Workplace Act of 1988, the City of Bisbee, as a federal grant recipient, is
required by federal law to certify to agencies from which it receives grants that it ensures a drug-free
workplace.
Accordingly, on August 17, 1990, the City of Bisbee’s “Drug Free Workplace Policy” went into effect. The policy
requires that all successful applicants for positions with the Police Department, the Fire Department, and
certain positions within the Public Works and other Departments, must pass a screening for drugs and alcohol.
Confidentiality of test results is maintained.
As a condition of hire, I understand that I will be asked to sign a pre-employment drug screening form. Failure
to do so, or a failure to pass said testing, will result in an automatic disqualification of my application for
employment as:
Position applied for:
Signature: _________________________________________ Date:
Name printed: