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Application for Employment

  1. City of Shenandoah Texas
  2. Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.
  3. Referral Source
  4. When is the best time to call you at home?
  5. May we contact you at work?
  6. If you are under 18 and it is required, can you furnish a work permit?
  7. Have you submitted an application here before?
  8. Are you legally eligible for employment in this country?
  9. Type of employment desired
  10. Will you relocate if job requires it?
  11. Are you able to meet the attendance requirements of the position?
  12. Will you work overtime if required?
  13. Have you ever been bonded?
  14. Have you ever been convicted of a crime in the last seven (7) years?
  15. Education Background
    A. List last three (3) schools attended, starting with most recent. B. List number of years completed. C. Indicate degree or diploma earned, if any. D. Grade Point Average or Class Rank. E. Major field of study. F. Minor field of study (if applicable).
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  19. References
    List name and telephone number of three business/work references that are not related to you and are not previous supervisors. If not applicable, list three school or personal references that are not related to you.
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  23. Additional Information
    List professional, trade business, or civic associations and any office held.
    Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability or any other similarly protected status.
  24. Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability or any other similarly protected status.
  25. Employment History
    Provide the following information for your past and current employers, assignments or volunteer activities, starting with the most recent. Explain any gaps in employment in comments section below.
  26. May we contact for references?
  27. May we contact for references?
  28. May we contact for references?
  29. Summarize any special training, skills, licenses and/or certificates that may qualify you as being able to perform job-related functions in the position for which you are applying.
  30. I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the employer’s service, whenever it is discovered.

    I give the employer the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability the employer and it representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information.

    The employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by local, state or federal law.

    This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

    If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or defined duration. I understand that no representative of this employer, other than an authorized officer, has the authority to make any assurances to the contrary. I further understand that any such assurances must be in writing and signed by an authorized officer.

    I understand it is this company’s policy not to refuse to hire a qualified individual with a disability because of that person’s need for a reasonable accommodation as required by the ADA.

    I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization.
  31. I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.
  32. Affirmative Action Voluntary Information
    We consider all applicants for positions without regard to race, color, religion, sex, national origin, age, mental or physical disabilities, veteran/reserve/national guard or any other similarly protected status.

    To be completed by applicant on a voluntary basis. Not for interview purposes. To be filed separately from application.

    In an effort to comply with requirements regarding government record keeping, reporting and other obligations which may apply, we invite you to complete this applicant data survey. Providing this information is strictly voluntary. Failure to provide it will not subject you to any adverse personnel decision or action. Your cooperation is appreciated.

    Please be advised that this survey is not a part of your official application for employment. It will not be used in any hiring decision. The information will be used and kept confidential in accordance with applicable laws and regulations.
  33. Referral Source
  34. Application Information
  35. Gender
  36. Ethnicity
  37. Leave This Blank:

  38. This field is not part of the form submission.