"Employment Application Form" - City of Athens, Texas

This ""employment Application Form" - City of Athens, Texas" is a part of the paperwork released by the Human Resources Department - City of Athens, Texas specifically for Texas residents.

The latest fillable version of the document was released on December 1, 2007 and can be downloaded through the link below or found through the department's forms library.

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CITY OF ATHENS
EMPLOYMENT APPLICATION
INSTRUCTIONS:
All applications for the City of Athens employment must be made on this form. This application form and its
attachments are official property of the City of Athens and will not be returned. If more space is needed to give full
answers or explanations attach additional pages. All information requested must be complete and accurate. A false,
incomplete or misleading response may result in disqualification for employment.
Name____________________________________
Social Security
#________________________
Mailing Address_________________________
Town________________________________
State_____________________________________
Zip Code
Telephone #_______________________________
Driver’s Lic. # and state_____________________
APPLICANT’S CERTIFICATION
I certify that all information contained on this application is true and complete to the best of my knowledge and
belief. I understand that the employment process may include drug screening, work fitness examination, medical
and psychological exam, and review of driving record. I give the City of Athens and its authorized agents
permission to verify any job-related information given in connection with this application. All new hire applicants
will be required to show proof of citizenship. I understand, if employed, that the City of Athens can change wages,
benefits and conditions at any time. I further understand that my employment can be terminated, with or without
cause, at any time at the discretion of the City, or myself. I further understand that no management official, other
than the City Manager, has the authority to enter into an agreement contrary to the foregoing or make any oral
assurance or promise of continued employment.
Applicant’s Signature_______________________________________ Date_____
City of Athens
508 E. Tyler St.
Athens, Texas
903-675-5131
EQUAL OPPORTUNITY EMPLOYER
CITY OF ATHENS
EMPLOYMENT APPLICATION
INSTRUCTIONS:
All applications for the City of Athens employment must be made on this form. This application form and its
attachments are official property of the City of Athens and will not be returned. If more space is needed to give full
answers or explanations attach additional pages. All information requested must be complete and accurate. A false,
incomplete or misleading response may result in disqualification for employment.
Name____________________________________
Social Security
#________________________
Mailing Address_________________________
Town________________________________
State_____________________________________
Zip Code
Telephone #_______________________________
Driver’s Lic. # and state_____________________
APPLICANT’S CERTIFICATION
I certify that all information contained on this application is true and complete to the best of my knowledge and
belief. I understand that the employment process may include drug screening, work fitness examination, medical
and psychological exam, and review of driving record. I give the City of Athens and its authorized agents
permission to verify any job-related information given in connection with this application. All new hire applicants
will be required to show proof of citizenship. I understand, if employed, that the City of Athens can change wages,
benefits and conditions at any time. I further understand that my employment can be terminated, with or without
cause, at any time at the discretion of the City, or myself. I further understand that no management official, other
than the City Manager, has the authority to enter into an agreement contrary to the foregoing or make any oral
assurance or promise of continued employment.
Applicant’s Signature_______________________________________ Date_____
City of Athens
508 E. Tyler St.
Athens, Texas
903-675-5131
EQUAL OPPORTUNITY EMPLOYER
CITY OF ATHENS
EMPLOYMENT
508 E. TYLER ST.
APPLICATION
ATHENS, TEXAS 75751
ANSWER ALL
QUESTIONS
-
PLEASE
PRINT
Applicants are considered for positions without regard to race, color, religion, sex, national origin, age, veteran status, or disability. The
City of Athens may conduct preemployment qualification assessment testing. If you require accommodation for the testing process, you
must notify Personnel when you submit your application.
Position applying for:
Applicants maybe required to describe or demonstrate that they can perform job related functions.
Name:
(first)
(middle)
(last)
Address:
(number and street)
(city, state, and zip code)
Telephone:
Social Security Number:
Telephone number(s) you can be reached at when not at above number:
Driver License Number:
Please check all hours that you are available to work:
full time
part-time
temporary
days
evenings/nights
weekends
shifts
Date
available to start work:
Have you ever filed an application here before? yes
()
no
()
If yes, give date
If you answer “Yes” to any of the following questions, please explain in full.
1. Are you now working for or have ever worked for the City of Athens?
If yes, please explain:
2. Do you or does your spouse have any relatives presently working or holding office for the City of Athens?
If yes, please explain:
3. Are you on a lay-off and subject to recall?
If yes, please explain:
4. Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?
If yes, please explain:
(If offered employment with the City of Athens you will be required within three (3) business days of beginning employment to
produce original legal documents that establish your identity and employment eligibility.)
5. Are you a veteran of the U.S. Military Service?
Yes
No If yes, Branch
List any professional, trade, business or civic activities and offices held. (You may exclude any which indicate race, color, religion, sex
or national origin):
Give name, address, and telephone number of three references who are not related to you and are not previous employers.
Have
you
ever
been
bonded?
If
yes,
for
which
position(s)
Have you ever been convicted of a felony?
If yes, please list convictions___________________________________________________
SPECIAL QUALIFICATIONS OR SKILLS: List qualifications and skills you may possess which are required for the job as stated in
the job announcement, such as typing speed, ability to operate specialized machinery or equipment, or professional registration or licensing.
Indicate any training you have had which is directly related to the job for which you are applying:
EMPLOYMENT
EXPERIENCE
List employers starting with most recent. Include military service or volunteer work. Exclude organization names which indicate race,
color, religion, sex, or national origin.
May we contact your present employer?
Yes
No
Employer:
Job Title:
Street Address:
City/State/Zip:
Phone Number:
Supervisor:
Beginning Employment Date:
Ending Employment Date:
Starting Hourly Rate/Salary:
Ending Hourly Rate/Salary:
Work Performed:
Reason for leaving:
Employer:
Job Title:
Street Address:
City/State/Zip:
Phone Number:
Supervisor:
Beginning Employment Date:
Ending Employment Date:
Starting Hourly Rate/Salary:
Ending Hourly Rate/Salary:
Work Performed:
Reason for leaving:
Employer:
Job Title:
Street Address:
City/State/Zip:
Phone Number:
Supervisor:
Beginning Employment Date:
Ending Employment Date:
Starting Hourly Rate/Salary:
Ending Hourly Rate/Salary:
Work Performed:
Reason for leaving:
IF YOU NEED ADDITIONAL SPACE, PLEASE CONTINUE ON A SEPARATE SHEET OF PAPER.
EDUCATION
High School:
Location:
Years Completed: (Circle)
9
10
11
12
Diploma:
College or University:
Location:
Years Completed: (Circle)
1
2
3
4
Degree:
Graduate or Professional:
Location:
Years Completed: (Circle)
1
2
3
4
Degree:
Describe Course of Study:
Honors
Received:
State Any Additional Information You Feel May Be Helpful To Us In Considering Your Application:
APPLICANT’S STATEMENT
I CERTIFY THAT THE STATEMENTS CONTAINED HEREIN ARE TRUE, COMPLETE, AND
CORRECT 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. I understand that this application is not and is not intended to be a contract of employment.
I understand that if I am offered employment with the City of Athens I will be required to take a post-offer physical examination and drug
test. Any offer of employment that I may receive will be conditioned upon the results of the post-offer physical examination and drug test.
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 City of Athens.
I elect the main Personnel Officer of the City of Athens to disclose my home address or home telephone number
for public information by signing yes or no, shown below. (Revised 03/200 1)
Yes
or
No
Applicants Signature in
Ink
Date
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