Download the Application for Employment

APPLICATION FOR EMPLOYMENT CITY OF EAST RIDGE 1517 Tombras Avenue East Ridge, TN 37412 The City of East Ridge is an EQUAL OPPORTUNITY EMPLOYER and does not discriminate on the basis of race, sex, color, religion, national origin, age, disability or veteran status in employment opportunities and benefits. Instructions: Complete a separate application form for each position you are applying for, unless otherwise specified. An employment application, unless otherwise specified, will be accepted only when a specific position opportunity notice is posted on the job vacancy board or City of East Ridge website, or advertised in various publications. Incomplete applications will not be processed. Position applied for: __________________________ Date: _______________________ Please write your name as it appears on your social security card: Name: ____________________________________________________________ Social Security No. __________________ Last First Middle Address: _____________________________________ ___________ Home Phone #: ________________ Number Street Apt. # ___________________________________________________________ Cell Phone #: ___________________ City State Zip Code Email Address: ________________________________________________ Have you ever worked for the City of East Ridge? Are you at least 18 years of age? Yes No Yes No If yes, indicated department and dated ________________ Do you have a driver’s license? Yes No ________________________________________________ State of Issuance: ______ Driver’s License Number: Are you related to any person currently employed by the Date of Expiration: ____________ _ Class:__________ City of East Ridge? Yes No If yes, indicate name, relationship, and department ________________________________________________ Can you provide the documents required to prove that ________________________________________________ you are authorized to work in the United States? ________________________________________________ Yes No Have you ever served with U.S. Armed Forces? Yes No Are there any other experiences, skills or qualifications If yes, what branch? _______________________________ which will be of special benefit in the job for which you Date entered active duty: ___________________________ are applying? _ Date discharged or separated: _______________________ _ Final Rank: _______________________________________ _ Special Training: __________________________________ Please list any special accommodations you would require Employment desired: for this position? ________________________________ Full-Time ______________________________________________ Part-Time If selected, the City requires a background check and will obtain additional forms from you. EDUCATION AND SPECIAL TRAINING Do you have a High School Diploma: Yes No GED? Yes No If not, highest grade completed: _______ Name and location of last High School Attended: _________________________________________________________ Name City State List Special Training (Business, Trade, Vocational, etc.) below: Total Hours Hours Required Name and Location Completed for Certification Course/Subject Taken Certifications Received List Colleges and Universities attended below: Credit Hrs. Did you Major/Minor Degree Type of Degree Name and Location Received Graduate? Course of Study Received EMPLOYMENT HISTORY List all positions that you have held, starting with your most recent. Include military experience and account for all periods you were unemployed. Name, Address and From To Phone Number Month/Year Month/Year Specific Duties Reason for Leaving Salary Supervisor Name, Address and From To Phone Number Month/Year Month/Year Specific Duties Reason for Leaving Salary Supervisor Name, Address and From To Phone Number Month/Year Month/Year Specific Duties Reason for Leaving Salary Supervisor Name, Address and From To Phone Number Month/Year Month/Year Specific Duties Reason for Leaving Salary Supervisor Name, Address and From To Phone Number Month/Year Month/Year Specific Duties Reason for Leaving Salary Supervisor PERSONAL REFERENCES (not former employers or relatives) Name Address Phone Number Number of Years Known ALL APPLICATIONS MUST BE SIGNED BY APPLICANT TO BE CONSIDERED PLEASE READ AND SIGN BELOW The facts set forth in my application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. In making this application for employment I authorize the City of East Ridge to make an investigative consumer report whereby information is obtained through personal interviews with personal references. This inquiry, if made, may include information as to my character, general reputation and personal characteristics. I understand that I have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of any such investigative report that is made. Signature of Applicant Date