Complete This Application in its Entirety
Position applied for:
First Name: Middle Name: Last Name:
Address:
City: State: Zip:
Phone:
Are you a U.S. Citizen? Yes No If not a citizen, indicate the type of permit in Block 17.
Have you ever been discharged or terminated for reasons other than a layoff or lack of work; or have you ever resigned to avoid discharge? Yes No If yes, explain in Block 17
Were you in the Armed Forces? Yes No
If so, which branch?
From Duty Date: To Duty Date:
Rank at Discharge Type of Discharge
Are you over the age of 18? (21 for Police and Fire)
Yes No
Do you have any relatives who work for the City of College Park?
Yes No If yes, give their name and relationship in Block 17.
Have you ever been employed by the City of College Park?
Yes No
How did you hear about this opportunity?
Newspaper GMA Website Other
List the equipment, software you can operate and level of proficiency.List any other names under which you have worked, applied for work, or attended school.
List any other names under which you have worked, applied for work, or attended school.
EDUCATION
List the names and locations of all schools attended.
High School Attended
From:
From: Total Months:
Major Course Work Degree/Certficate:College/University/TechnicalFrom:
From: To:
Major Course WorkDegree/CertificateSchool 3:
From: To:
Major Course Work: Degree/Certificate:
EXPERIENCE
Begin with your current or most recent employment. List all jobs, including military service, along with periods of unemployment. Busure to describe the work you did fully and make note of any promotions you recievied. Attach additional pages if necessary.
Employer 1 Name and Location:
Title:
Responsibilities:
Full Time: Yes No
From: To:
Total Months:
Beginning Salary Ending Salary
Supervisor's Name:
Telephone: Reason for Leaving:
May we contact?
Yes No
Employer 2 Name and Location:
Title:
Responsibilities:
Full Time:
Yes No
From: To:
Total Months:
Begin Salary: End Salary:
Supervisor's Name:
Telephone:
Reason for Leaving:
May we contact?
Yes No
Employer 3 Name and Location:
Title:
Responsibilities:
Full Time:
Yes No
From:
To: Total Months:
Begin Salary: End Salary:
Supervisor's Name:
Telephone:
Reason for Leaving:
May we contact?
Yes No
Other Information:
Personal References
List three persons who have knowledge of your character or abilities. Do not include relatives or former supervisors.
Please include the reference name, address, phone, and business/occupation for each.
Reference 1:
Reference 2:
Reference 3:
Electronic Signature
Certification
I hereby certify that the answers given by me to the foregoing questions and statements made by me are -full and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application or any supplements thereto, is cause tor rejection of my application or discharge at any time during my employment. I voluntarily authorize my former employers, schools, and persons named herein to give information regarding me. I hereby release said organizations or persons from any liability or damages whatsoever. I also authorize a background investigation to be carried out, to include a City sponsored lie detector test.
I understand that as a condition of employment, I will be required to pass an employment physical (including drug screen) and any future physical examination required by the City. I understand that such employment is subject to the policies of the City and the passing of any required written, physical agility, or skill examination. It is understood that the use of this form does not indicate that there are any position openings, and does not in any way obligate the City.
Candidates are subject to a background investigation.
Applicant Signature: Date:
An Equal Opportunity Employer
The following is to be completed on a voluntary basis and will be separated from the application. Information will be used on a composite basis for statistical and compliance reporting purposes. Failure to complete will in no way affect consideration of your application.
Position applied for:
Age: Race: Sex: Marital Status: Date:
Email address:
Please email your resume to jobs@collegeparkga.com
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