cityofhillsboro

Application for Employment

An Equal Opportunity / Affirmative Action Employer

If you need assistance in completing the employment application, please inquire at the personnel office. Furthermore, this employer conducts pre-employment qualification testing and personal interviews in the application process. If you believe you will require reasonable accommodation (e.g., interpreter, TDD, scheduling adjustments) for pre-employment testing or a personal interview, you must notify the personnel office at least 24 hours prior to the scheduled test or interview.

PERSONAL INFORMATION

Last Name*

First Name*

Middle Initial

Street Address, RFD, or P.O. Box*

City

State/Province

Zip Code

Phone*

Social Security Number

Position(s) applied for

When would you be able to start work?

Check each type of work you will accept

Regular

Temporary

Part-Time

Full-Time

Have you filed an application here before?

Yes

If yes, when?

Have you ever been employed here before?

Yes

If yes, when?

What is your proficiency in English?

Read

Speak

Write

What is your proficiency in Spanish?

Read

Speak

Write

Are you or your spouse related to any elected official or employee of the City?

Yes

If yes, list the name(s) of relative(s) and their relation to you.

Minimum acceptable salary: $

Hour

Week

Month

Year

EDUCATION & TRAINING

Name of School Attended and Location

Dates Attended

Average Grades

Major Field

Degree Received

Name of School Attended and Location

Dates Attended

Average Grades

Major Field

Degree Received

Name of School Attended and Location

Dates Attended

Average Grades

Major Field

Degree Received

SKILLS

Computer

IBM-PC

WPM

Macintosh

WPM

Other

Specify

Equipment

Standard business copier(s)

Calculator (by touch)

Photography equipment

Specify

PBX or other switchboard

Other equipment

Specify

Software Proficiency

WordPerfect

Version

Microsoft Word

Version

Other word processor

Specify

Lotus 1-2-3

Version

Microsoft Excel

Version

Other spreadsheet

Specify

Database

Specifiy

Desktop Publishing

Specify

Other software

Specify

Please list any other job-related special training or interests

List each position held, beginning with your present or most recent assignment and work backward. A resume may be submitted to supplement this information, but the information below must still be completed.

May we contact your present employer?

Yes

Employer #1

Address*

Dates to - From

Job Title

Summary of Job Duties

Supervisor

Reason for Leaving

Starting Salary

Ending Salary

Employer #2

Address*

Dates to - From

Job Title

Summary of Job Duties

Supervisor

Reason for Leaving

Starting Salary

Ending Salary

Employer #3

Address*

Dates To - From

Job Title

Summary of Job Duties

Supervisor

Reason for Leaving

Starting Salary

Ending Salary

Employer #4

Address*

Dates To - From

Job Title

Summary of Job Duties

Supervisor

Reason for Leaving

Starting Salary

Ending Salary

ADDITIONAL INFORMATION

By law, you must be authorized to work in the United States in order to be employed by this employer. If you are one of the following, please check this box

o A citizen or a national of the United States
o An alien lawfully admitted for permanent residents
o An alien authorized by the Immigration & Naturalization Service to work indefinitely in the United States

Have you ever been convicted of a felony or other crime?

Yes

If yes, please explain in the space below. (You may omit convictions for minor traffic violations unless the position for which you are applying requires the operation of a motor vehicle. Conviction will not result in your automatic disqualification for employment. The seriousness of the crime, date of conviction, and the relevance of the crime to this position will be considered.)

If the position for which you are applying requires operation of a motor vehicle, do you have a valid Texas driver's license?

Yes

If yes, license number

If yes, type of license

Operator

Commercial

Class

Chauffeur

REFERENCES

List three (3) persons not related to you who are qualified to describe your capabilities for the position you seek.

Reference #1

Name*

Address*

Phone*

Occupation

Reference #2

Name*

Address*

Phone*

Occupation

Reference #3

Name*

Address*

Phone*

Occupation

AUTHORIZATION & CERTIFICATION

I hereby authorize the City of Hillsboro to obtain and review all of my employment, educational, military, and criminal records. In addition, I authorize the City of Hillsboro to obtain and review information regarding my financial status and general reputation.

I certify that the statements and information contained herein are true, complete, and correct to the best of my knowledge, and I authorize any former employer to release to the City of Hillsboro or its authorized representative any and all employment records and other information it may have about my employment. I understand that the information will be used for the purpose of evaluating my application for employment and that I am responsible for providing legal documents verifying my identity and eligibility for employment. In addition, I understand that, if selected for an interview, true copies of all degrees, certificates, or licenses listed on this application will be required before an employment decision can be made. A photocopy of this authorization shall be valid as the original.

I understand and agree that employment will be contingent upon me satisfactorily passing a drug and alcohol test as well as a physical exam. Further, I understand and agree that, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time, and that intentional misrepresentation on my application or during the interview process will subject me to immediate discharge. I also understand that only written representation and promises of this employer will be enforceable.

Electronic Signature of Applicant

Date Signed

Please attach your resume

Please attach any supporting documents

Application for Employment

PERSONAL INFORMATION

EDUCATION & TRAINING

SKILLS

REFERENCES

Reference #1

Reference #2

Reference #3

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