Employment Application Position(s) Applied for: (required) Date of Application (required) How did you learn about us? (required) Advertisement Employment Agency Friend/Relative Walk-In Indeed.com, etc. Last Name (required) First Name (required) Middle Name Address (required) City (required) State (required) Zip Code (required) Telephone No. (required) Email (required) If you are under the age of 18, can you provide required proof of your eligibility to work? (required) Yes No Have you ever filed an application with us before? (required) Yes No Have you ever been employed with us before? (required) Yes No Are you currently employed? (required) Yes No May we contact your employer? (required) Yes No Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status: (proof of citizenship or immigration status will be required upon employment) (required) Yes No On what date would you be available for work? (required) Are you available to work: (required) Full Time Part Time Are you currently on "lay-off" status and subject to recall? (required) Yes No Can you travel if a job requires it? (required) Yes No Have you been convicted of a felony within the last 7 years? (Conviction will not necessarily disqualify an applicant from employment) (required) Yes No If yes, explain: (required) Education Name of High School Attended: (required) Years completed (required) Diploma/Degree (required) Name of College Attended (required) Course of Study (required) Years Completed (required) Degree (required) Other School Attended (required) Years Completed (required) Describe any specialized training, apprenticeship, skills and extra-curricular activities: (required) Describe any job-related training received: (required) Employment History (Start with present or last job) Employer (1) (required) Employer Address (required) Employer Telephone No.: (required) Job Title (required) Dates Employed: (required) Supervisor Name: (required) What was your hourly rate: (Start/Final) (required) Summarize your job responsibilities: (required) Reason for Leaving: (required) Employer (2) (required) Employer Address: (required) Employer Telephone No.: (required) Job Title: (required) Dates Employed: (required) Supervisor Name: (required) What was your hourly rate: (Start/Final) (required) Summarize your job responsibilities: (required) Reason for leaving: (required) Employer (3) (required) Employer Address: (required) Employer Telephone No.: (required) Job Title: (required) Dates Employed: (required) Supervisor Name: (required) What was your hourly rate: (Start/Final) (required) Summarize your job responsibilities: (required) Reason for leaving: (required) List professional, trade business or civic activities and offices held: (required) Additional Information Other Qualifications (Summarize special job-related skills and qualifications acquired from employment or other experience): (required) Specialized Skills (required) PC Calculator Microsoft Word Excel Power Point Other: State any additional information you feel may be helpful to us in considering your application: (required) References: Name: (required) Address: (required) Telephone No. : (required) Name: (required) Address: (required) Telephone No.: (required) Driver Experience/Qualifications: Drivers License No. (required) Drivers License State (required) Drivers License Type (required) Drivers License Expiration Date: (required) Have you ever been denied a license, permit or privilege to operate a motor vehicle: (required) Yes No If yes, please explain: (required) Has an license, permit or privilege ever been suspended or revoked? (required) Yes No if yes, please explain: (required) Applicant's Statement "I certify that the information provided in this application is true and complete. I understand that any false or misleading information or omissions may result in my disqualification from consideration or, if hired, my immediate termination. I understand that this application is not an offer or a contract of employment. If I am hired, my employment will be 'at-will,' meaning that either the Fountain Sanitation District or I may terminate the relationship at any time, for any reason, with or without notice or cause. No representative of the Fountain Sanitation District, other than District Management, has the authority to enter into any agreement contrary to the at-will relationship, and any such agreement must be in writing. I authorize the Fountain Sanitation District to investigate all statements in this application and to contact my prior employers and references. I release all parties from any liability for providing such information. Fountain Sanitation District is an Equal Opportunity Employer and does not discriminate in hiring or employment on the basis of race, color, religion, national origin, sex, age, disability, or any other characteristic protected by law." Resume (pdf preferred) (required) Your Signature (required) Confirm e-Signature Review Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signatures There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
