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2. 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.

4. Position Applied For
5. Date
   Date
7. You must be capable of performing in a reasonable manner, with or without reasonable accomodations, the activites involved in the job or occupation for which you have applied.
   A description of the activities involved in job requested should be requested prior to completing this application.
9. How did you learn about this position?

   Check all that apply.

   1. Advertisement
   2. Employment Agency

   1. Friend
   2. Relative

   1. Walk-In
   2. Other
11. Applicant Information
13. First Name
14. Last Name
16. Phone
18. Street Address
20. Mailing Address
22. City
23. State
24. Zip
28. If you are under 18 years of age, can you provide requied proof of your eligibility to work?

    1. Yes
    2. No
    3. N/A
30. Have you ever filed an application with us before?

    1. Yes
    2. No
    3. N/A
32. Have you ever been employed with us before?

    1. Yes
    2. No
    3. N/A
34. Are you currently employed?

    1. Yes
    2. No
    3. N/A
35. May we contact your present employer?

    1. Yes
    2. No
    3. N/A
37. Are you prevented from lawfully becoming employed in the country because of Visa or Immigration Status?

    Proof of citizenship or immigration status will be required upon employment.

    1. Yes
    2. No
    3. N/A
39. On what date will you be available for work?
40. Date
    Date
41. Are you available to work?

    Check all that apply.

    1. Full Time
    2. Part Time
    3. Shift Work
    4. Temporary
43. Are you currently on "lay-off" status and subject to recall?

    1. Yes
    2. No
    3. N/A
45. Can you travel if a job requires it?

    1. Yes
    2. No
    3. N/A
47. Have you been convicted of a felony within the last seven years?

    Conviction will not necessarily disqualify an applicant from employment.

    1. Yes
    2. No
    3. N/A
49. You will be required to present a criminal background check from the Bureau of Criminal Identification if you are considered for hire. Are you agreeable?

    1. Yes
    2. No
    3. N/A
51. Skills and Qualifications
    Summarize special job-related skills and qualifications acquired from employment or other experience.
53. Check Skills

    Office Equipment

    1. Personal Computer
    2. Calculator
    3. Mobile Devices
    4. Copier-Fax-Scan
    5. Other
54. Check Skills

    Computer Software

    1. Windows Products
    2. Apple Products
    3. GIS Mapping
    4. Word Perfect
    5. MS Word

    1. MS Excel
    2. Adobe Reader
    3. Adobe Professional
    4. CAD
    5. Caselle Accounting
56. List Equipment Operated
58. Summarize any additional information that you feel may be helpful to us in considering your application.
60. Note to applicant:
    Do not answer this question unless you have been informed about the requirements of the job for which you are applying.
62. Are you capable of performing in a reasonable manner, with or without reasonable accommodations, the activities involved in the job or occupation for which you have applied?

    You should request and read the activities of the job you are applying for prior to answering this question.

    1. Yes
    2. No
    3. N/A
66. Enter at least three (3) References.
68. First Name
69. Last Name
71. Phone
73. Street Address
75. Mailing Address
77. City
78. State
79. Zip
81. First Name
82. Last Name
84. Phone
86. Street Address
88. Mailing Address
90. City
91. State
92. Zip
94. First Name
95. Last Name
97. Phone
99. Street Address
101. Mailing Address
103. City
104. State
105. Zip
109. Applicant's Acknowledgment
     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 as 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 45 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 herby 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 writhing 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.
111. Email
113. A resume is required before processing of this application can begin.
115. Signature of Applicant
116. Date
     Date
Leave This Blank:


118. 1. Receive an email copy of this form.
119. Email address

     This field is not part of the form submission.

120. Submit

* indicates a required field