APPLICATION FOR EMPLOYMENT
We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status
Position(s) Applied For
How did you learn about us? Advertisement, Relative, Inquiry, Employment Agency, Friend, or Other? (type one)
Date of Application
Last Name
First Name
Middle Name
Applicant's Email Address
Address (Number, Street, City, State, Zip Code)
Home Phone Number
Cellular Phone Number
Current Work Phone Number
Social Security Number
Best time to contact you
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?Yes No
If yes, give date
Have you ever been employed with us before?Yes No
If yes, give dates
Do any of your friends or relatives, other than spouse, work here?Yes No
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 (NOTE: Proof of citizenship or immigration status will be required upon employment)?Yes No
Date available for work
Desired hourly rate (THIS BLANK MUST BE COMPLETED FOR YOUR APPLICATION TO BE ACCEPTED; "NEGOTIABLE" IS NOT A PROPER RESPONSE).
Are you available to work:Full-Time Part- Time Temporary
If Full-Time, please indicate which shift (1, 2, or 3)
If Part-Time, please indicate Mornings, Afternoons, or Evenings:
If Temporary, please indicate dates available:
Are you currently on "lay-off" status or subject to recall?Yes No
Can you travel if the job requires it?Yes No
Name and Address of your Elementary School, Courses of Study, Years Completed, and whether a Diploma or Degree was earned:
Name and Address of your High School, Courses of Study, Years Completed, and whether a Diploma or Degree was earned:
Name and Address of your Undergraduate College, Courses of Study, Years Completed, and whether a Diploma or Degree was earned:
Name and Address of your Graduate/Professional School, Courses of Study, Years Completed, and whether a Diploma or Degree was earned:
Name and Address of any other School, Courses of Study, Years Completed, and whether a Diploma or Degree was earned:
Describe any specialized training, apprenticeships, skills, and extra-curricular activities:
Describe any job-related training received in the United States military
PREVIOUS EMPLOYER #1
Employer's Name, Address, Telephone Number, Your Job Title, Your Supervisor, Your Reason for Leaving, Employment Date Range, & Salary Range.
Describe duties performed:
PREVIOUS EMPLOYER #2
Describe Duties Performed:
PREVIOUS EMPLOYER #3
PREVIOUS EMPLOYER #4
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):
Other Qualifications (summarize special job-related skills and qualifications acquired from employment or other experience):
Check Skills:Terminal PC/MAC Typewriter Spreadsheet Word Processing Shorthand
Specify the WPM for Shorthand and Typewriter (if applicable)
List the all Production/Mobile Equipment you can operate:
State any additional information you feel may be helpful to us in considering your application
NOTE TO APPLICANTS: DO NOT ANSWER THE FOLLOWING QUESTION 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 review of the activities involved in such a job or occupation is available at city hall)?Yes No
REFERENCE #1
Name, Address, & Phone Number
REFERENCE #2
REFERENCE #3
BY TYPING YOUR FULL NAME IN CAPS IN THE FOLLOWING BLANK, YOU ARE CERTIFING THAT THE ANSWERS GIVEN HEREIN ARE TRUE AND COMPLETE. YOU 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 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. THE APPLICANT HEREBY ACKNOWLEDGES THAT, UNLESS OTHERWISE DEFINED BY APPLICABLE LAW, ANY EMPLOYMENT RELATIONSHIP WITH THE CITY OF COMMERCE IS OF AN "AT WILL" NATURE, WHICH MEANS THE EMPLOYEE MAY RESIGN AT ANY TIME AND THE EMPLOYER MAY DISCHARGE THE EMPLOPEE 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, YOU UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN THIS APPLICATION OR ANY INTERVIEW(S) MAY RESULT IN TERMINATION. YOU UNDERSTAND, ALSO, THAT YOU ARE REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF THE EMPLOYER.
THE "NOTICE TO APPLICANTS" AND "CONSENT TO BACKGROUND INVESTIGATION" MUST BE SUBMITTED IN CONJUNCTION WITH THIS APPLICATION FOR THE APPLICATION TO BE CONSIDERED.
Signature of Applicant (Must be in all CAPS to be accepted):
Date of Application:
