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Job Application
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Steps
1.
Personal Information
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This section is incomplete
2.
Position Information
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3.
Education
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4.
Employment History
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5.
Field Employment (if applicable)
This section is complete
This section is incomplete
6.
Office Employement (if applicable)
This section is complete
This section is incomplete
7.
References
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8.
Disclaimer & Signature
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Personal Information
Last Name
*
First Name
*
Middle Name
Address1
*
Address2
City
*
State
*
Zip
*
Phone Number
*
Email Address
*
Upload Your Resume
If employed and you are under 18, can you furnish a work permit?
Yes
No
Do you have a current, valid driver's license?
*
Yes
No
List professional trade, business, or civic activities and offices held. (You may exclude those which indicate a protected class):
Summarize any additional special skills and qualifications acquired from employement of other experience that you feel may be helpful in considering your application:
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Position Information
Which position are you applying for?
*
Type of employment desired
*
Full Time
Part Time
Internship
Temporary
How did you hear about the position?
*
On what date would you be available for work?
*
Have you filed an application here before?
*
Yes
No
If yes, give date
Have you ever been employed here before?
*
Yes
No
If yes, give start date
Are you on layoff and subject to recall?
*
Yes
No
Can you travel if the job requires it?
*
Yes
No
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Education
High School
Diploma/Degree/Certification Received
College
Diploma/Degree/Certification Received
Describe Course of Study
Graduate/Professional
Diploma/Degree/Certification Received
Describe Course of Study
Honors Received:
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Employment History
Are you employed now?
*
Yes
No
If yes, may we contact your current employer?
*
Yes
No
Can you provide proof of your legal right to work in the U.S.?
*
Yes
No
(From Most Recent)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
Yes
No
Address
Responsibilities
Employed From - To (Date)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
Yes
No
Address
Responsibilities
Employed From - To (Date)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
Yes
No
Address
Responsibilities
Employed From - To (Date)
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Field Employment (if applicable)
Water Works Experience:
Water Works Education:
Filtration Plant Employement:
Name of Plant
Type of Plant
MGD of Plant
How Long at Plant?
Current Water Treatment Operator's Certification:
Operator Grade
Date Issued
Issuing Agency
Current Water Distribution Operator's Certification:
Operator Grade
Date Issued
Issuing Agency
Can you operate a Backhoe?
never tried
moderately well
proficient
If yes, what type of backhoe
What type of construction or plumbing work have you performed and what equipment have you operated?
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Office Employement (if applicable)
Computer skills; list programs/software and level of expertise:
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References
Please provide the name, address and telephone number of three personal references that are not related to you and are not previous employers.
Full Name
*
Relationship
*
Phone Number
*
Full Name
*
Relationship
*
Phone Number
*
Full Name
*
Relationship
*
Phone Number
*
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Disclaimer & Signature
I certify that my answers are true and complete to the best of my knowledge and that intentional misrepresentations or omissions may be cause for the rejection of my application and that if hired I may be released from employment.
I understand that the company may require me to successfully complete a pre-employment drug and alcohol test and a background check as a condition of employment and that continued employment may be based on the successful completion of similar tests.
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
Applicant Signature
*
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