Fillable kadelphia City of Ar Application for Employment (City of Arkadelphia)

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kadelphia City of Ar Application for Employment (City of Arkadelphia)

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The kadelphia City of Ar Application for Employment (City of Arkadelphia) form is 4 pages long and contains:

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Country of origin: US
File type: PDF

U.S.A. forms for City of Arkadelphia

BROWSE CITY OF ARKADELPHIA (AR) FORMS

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City of Ar
kadelphia
Application for Employment
Name: _______
_________________ ______________________ _______________________________
Last First Middle
Mailing
Address: __________________________ _______________________ _________ _________
Street City State Zip
Telephone number: ___________________________________________________________________
Position Applying for: __________________________________________________________________
Can you perform the duties (essential function of the job), with or without a reasonable
accommodation? Yes No
Minimum salary requirement: ___________________________________________________________
Employment History: List all employment (including military service) for at least the past five years.
Begin with your current employer and complete from most recent to previous. Attach additional
sheets if more space is needed.
Current Employer: May we contact this employer? Yes No
Company: _________________________________ Job Title: ___________________________________
Address: ___________________________________________________ Telephone: _______________
Supervisor: _______________ Salary: _______ Employment Dates: from ___________ to ___________
Reason for Leaving: ____________________________________________________________________
List job duties: ________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Previous Employers:
Company: _________________________________ Job Title: __________________________________
Address: ___________________________________________________ Telephone: _______________
Supervisor: _______________ Salary: _______ Employment Dates: from __________ to ____________
Reason for Leaving: ____________________________________________________________________
List job duties: ________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
City of Arkadelphia
Application for Employment
Company: _________________________________ Job Title: ___________________________________
Address: ___________________________________________________ Telephone: _______________
Supervisor: _______________ Salary: _______ Employment Dates: from ___________ to ___________
Reason for Leaving: ____________________________________________________________________
List job duties: ________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Company: _________________________________ Job Title: __________________________________
Address: ___________________________________________________ Telephone: _______________
Supervisor: _______________ Salary: _______ Employment Dates: from __________ to ____________
Reason for Leaving: ____________________________________________________________________
List job duties: ________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Education
High School Graduate: Yes No If not, have you recieved a GED: Yes No
Highest grade completed: (12=HS grad, 16=BA/BS degree, 18=MS/MA) _________
List all college, business, or trade school courses or degrees completed:
School Name
Subject/Degree Completed
Dates
Attach additional sheets if more space is needed
List all licenses/certifications you hold (drivers, water/wastewater, CDL, plumbing insp., electrician,
lifeguard, etc.) _________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
City of Arkadelphia
Application for Employment
List equipment, office machines, and computer programs you have experience operating:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Please list any additional experience, skills, or training you have had which would help you
qualify for the position you are seeking: ____________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Other Information
Are you related to any current City employees or any member of the Board of Directors? Yes No
If yes, please give name and relationship: __________________________________________________
References:
Give the names and address of three (3) persons (not relatives) who have knowledge of your
experience, abilities, and knowledge.
Name
Address
Phone Number
Have you ever been convicted of a violation of the law (other than minor traffic violations)? Yes No
If yes, list details to include dates and violation history: ________________________________________
(Convictions do not automatically disqualify you from employment)
Please list any languages you speak, other than English: _______________________________________
City of Arkadelphia
Application for Employment
CERTIFICATION:
I hereby certify that all information I have supplied is true and factual. I agree and understand that
any false, misleading, or incomplete information, regardless of time of discovery, may cause my
dismissal of employment or rejection as an applicant.
I am eligible for employment (per the Immigration and Reform Control Act of 1986) in the United
States and will provide proper documentation should I be hired.
I understand certain jobs may require an acceptable driver's safety record, and that if my current or
future driver's record is unacceptable, my application may be rejected, and if hired, I may be subject
to termination.
Certain jobs may require a physical and /or psychological exam. I understand these selected job offers
will be conditional upon passing the required examination.
I give permission for you to check the references I have provided and for the persons contacted to
answer your questions about me. I also understand previous employers will be contacted and I will
sign a consent for employment records release.
I understand that this application does not create any contractual or other legal rights. It does not
alter the at-will employment status nor does it create an employment contract for any specified
period of time.
Signature of Applicant: ___________________________________________ Date: _________________
All job offers are subject to approval by the City Manager. This application is the property of the City of
Arkadelphia and will become part of the applicant's personnel file if accepted for employment.
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kadelphia City of Ar Application for Employment (City of Arkadelphia)

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Completed 25 March 2022

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