City of Everman Job Application

Application for Employment
Position Applying For:
Full Name *

First Name Middle Initial Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
example@example.com
Phone Number *

Area Code Phone Number
Date of Birth *

Month Day Year
Date
Available start date: *

Month Day Year
Date
Do you have a valid driver's license? *

Yes No
State
Number
Are you authorized to work and remain in the United States? *

Yes No
Were you ever discharged or forced to resign from any position? *

Yes No
If Yes, Explain:
Have you ever been employed by the City of Everman? *

Yes No
Position:
Department:
Are you related to any City of Everman employee? *

Yes No
Name of Employee:
Relationship:
Department:
Have you served in the U.S. Armed Forces?

Yes No
If Yes, Branch:
Date Entered Active Duty:

Month Day Year
Date
Date Released Active Duty:

Month Day Year
Date
Have you ever been convicted of any violation of the law? (Exclude traffic violations) A conviction will not necessarily disqualify an applicant from the position sought. *

Yes No
If Yes, Explain:
Education:
Are you a High School Graduate? *

Yes No
High School Equivalency? *

Yes No
Are you presently attending school? *

Yes No
Type of Education
Name of Instiution
Field of Study
Type of Degree
Did you Graduate?

Yes No
Do you have additional education to enter?

Yes No
Additional Type of Education
Name of Instiution
Field of Study
Type of Degree
Did you Graduate?

Yes No
Professional License or Certificate, If Required
Type
License Number
Date Issued
Expiration Date

Month Day Year
Date
Skills
Typing Words Per Minute:
Don't know? visit: www.typingtest.com
10 Key Speed:
Word Processing:

Yes No
List Computer Background and Years of Experience:
Equipment Operated:
Employment History

Beginning with your present or most recent experience, account for all employment during the past ten (10) years. To elaborate, a supplemental sheet or resume may be attached, but cannot be substituted for a completed application. Include military service if applicable.
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Supervisor:
Ending Salary Per Month:
Date started

Month Day Year
Date
Date ended

Month Day Year
Date
Reason for Leaving:
Description of Duties:
Do you have additional employers to enter?

Yes No
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Supervisor:
Ending Salary Per Month:
Date started

Month Day Year
Date
Date ended

Month Day Year
Date
Reason for Leaving:
Description of Duties:
Do you have additional employers to enter?

Yes No
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Supervisor:
Ending Salary Per Month:
Date started

Month Day Year
Date
Date ended

Month Day Year
Date
Reason for Leaving:
Description of Duties:
Do you have additional employers to enter?

Yes No
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Supervisor:
Ending Salary Per Month:
Date started

Month Day Year
Date
Date ended

Month Day Year
Date
Reason for Leaving:
Description of Duties:
Inquiry may be made of your current and former employers/schools you attended.
May we contact your present employer?

Yes No
May we contact your former employers?

Yes No
Personal References
Full Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Business or Occupation
Phone Number

Area Code Phone Number
Do you have more personal references to add?

Yes No
Full Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Business or Occupation
Phone Number

Area Code Phone Number
Do you have more personal references to add?

Yes No
Full Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Business or Occupation
Phone Number

Area Code Phone Number
APPLICANT’S STATEMENT AND AUTHORITY TO RELEASE INFORMATION

(Required for ALL Positions)

I understand that this employment application and any other city documents are not contracts of employment, and any person hired may be terminated by the employer at any time for any reason. I understand that any oral or written statements to the contrary are expressly disavowed and should not be relied upon by a prospective or existing employee. I understand that the City of Everman may modify, change, or revoke any of its employment policies, pay practices, and benefits without my agreement. I hereby state that all answers on this application are true and understand that falsifying this information can lead to termination if hired.

I UNDERSTAND THAT IN ACCORDANCE WITH CITY POLICY, FINAL CANDIDATES ARE SUBJECT TO AN ALCOHOL / DRUG TEST AS A CONDITION OF EMPLOYMENT.

I hereby authorize any and all persons, companies, or agencies to release any and all background information, of a confidential or privileged nature, including criminal history, relevant to this application and any pertinent information they may have to the hiring authorities of the City of Everman. I release all such parties from all liability of every kind as the result of furnishing the same to the City of Everman.

This information is to be used to assist the City in determining my qualifications and fitness for the position I am seeking. I hereby release the City of Everman and its officers, agents and employees from any liability for the use of any and all of the foregoing information, in consideration for being reviewed for the aforesaid position. Should there be any questions regarding the validity of this release, you may contact me as indicated below.

Jennifer Nateros

Director of Human Resources

817-293-0525

jnateros@evermantx.net
Full Name
Phone Number

Area Code Phone Number
Date

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Please Sign Here

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Upload any additional files that you would like considered
EQUAL EMPLOYMENT OPPORTUNITY QUESTIONAIRE
The following information we are soliciting is strictly voluntary. This form will be kept separate and confidential from the application.

Information provided on this form will not be considered in any employment decision but is for statistical purposes only.
Tilte of Position Applied for:
Date

Month Day Year
Date
Full Name

First Name Last Name
Age
Gender

Male Female
Race/Ethnic Origin (Select ONLY One)

White (not of Hispanic origin): Persons having origins in any of the original people of Europe, North Africa, or the Middle East. Black (not of Hispanic origin): Persons having origins in any of the black racial groups of Africa. Hispanic: Persons of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish cultures or origins regardless of race. Asian or Pacific Islander: Persons having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This includes, for example, China, India, Japan, Korea, the Philippine Islands, and Samoa. American Indian or Alaskan Native: Persons having origins in any of the original people of North American and who maintain cultural identification through tribal affiliation or community recognition.
How did you learn about this position?

Employment Office City Employee School Newspaper Internet Career Fair Walk-In
Do you have any physical or mental disabilities which may limit your ability to perform essential functions of this job or which would require any special accommodations?

Yes No
If Yes, Please explain:
Please verify that you are human *
Should be Empty:

Application for Employment

Education:

Professional License or Certificate, If Required

Skills

Employment History

Personal References

EQUAL EMPLOYMENT OPPORTUNITY QUESTIONAIRE