City Application

City Application

*Position Applying For

*Name Last, First, Middle

*Address Number, Street, City, State, Zip

*Email Address

*Phone

Date Of Birth

Social Security Number

Do you have a valid driver's license?

State Issued

If you are under 18 years of age, can you provide proof of your eligibility to work?

Have you ever been employed by the City of Horn Lake?

If yes, provide dates

Do any of your friends or relatives work here?

If yes, provide name, relationship and department

Have you ever been convicted of, or plead guilty or no contest to, a crime other than a minor traffic violation?

Are you currently employed?

May we contact your present employer?

Are you a U.S. citizen, or are you legally authorized to work in the U.S.? NOTE: Proof of citizenship or authorization to work in the United States may be required.

On what date would you be available to begin work?

Are you available to work? Full Time Part Time Shift

Are you currently on “lay-off” status and subject to recall?

Will you be able to travel if the job requires such?

Employment History Employer, Work Dates, Location, Contact

EDUCATION

High School Name and Address of School

Received:

College, University or Professional School Name and Location of School, Course of Study, Credit Hours Earned, Did you graduate? Degree

Job-Related Training or Course Work Name and Location of School How many years did you attend? Course of Study

Describe any specialized training, skill, or qualifications you possess (ex: speak any language other than English, operate specialty equipment)

List professional, trade, business, or civic activities and offices held, if applicable. (You may exclude memberships, which would reveal sex, religion, national origin, age, ancestry, handicap or other protected status)

Upload Employment History and References