DURHAM COUNTY ABC BOARD EMPLOYMENT APPLICATION

DURHAM COUNTY ABC BOARD

2634 Durham Chapel Hill Blvd. Suite 10, Durham, NC 27707 Phone: (919) 419-6217 Fax: (919) 489-0933 www.durhamabc.com
THE EMPLOYMENT PROCESS
1. APPLICATION FILE: APPLICANTS MUST HAVE A COMPLETE APPLICATION FILE BEFORE BEING CONSIDERED FOR AN INTERVIEW. A COMPLETE FILE CONSISTS OF THE FOLLOWING ITEMS:
  - Application for Employment, a resume is optional
  - A minimum of two (2) references
2. REFERENCES: Obtain references from persons who have firsthand knowledge of your qualifications. It is the responsibility of the applicant to have his/her two (2) reference forms returned to the Administrative Office.
3. SELECTION: When it is determined that there is a vacant position, qualified applicants are invited for interviews.
4. EMPLOYMENT NOTIFICATION: ONLY the General Manager or his/her designee is authorized to grant notification of employment. When the selected applicant is notified the terms of employment,
  starting date and all pertinent information will be explained. All forms, such as withholding, should be filled out prior to employment.
5. APPLICATION UPDATE: Applications are kept on active file for one year of their receipt. They are maintained in an inactive file during the second year and are re-activated upon written request only.
SPECIAL NOTE

Please do not call or visit our office to check the status of an application. As stated above, persons selected for interviews will be contacted when there is a vacancy.
EMPLOYMENT APPLICATION

POSITION FOR WHICH APPLICATION IS BEING MADE
First Choice *
Second Choice
Do you wish to work *

Full-time Part-time
Shift Availability *
Hourly/annual salary expected
Date available to work

Month Day Year
Date
PERSONAL DATA
Name

Note: Please enter your name as it appears on your social security card.
Name *

First Name Middle/Maiden Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone

Area Code Phone Number
Message Phone *

Area Code Phone Number
Email Address
example@example.com
Have you ever been convicted of any offense? *

Yes No
If you answered YES above, please indicate when, where and disposition of offense.
Are you related to anyone currently employed with the Durham County ABC Board? *

Yes No
If YES, please list the name of the employee and your relationship.
US Citizen? *

Yes No
If not a US Citizen, are you eligible to work in the US?

Yes No
Education *
Please select the highest level of education completed
High School Name or Equivalent
High School Location
Diploma Received? *

Yes No
Name of College/University/Technical/Vocational School
Location of College/University/Technical/Vocational School
Degree/Major
EMPLOYMENT HISTORY

Beginning with present or most recent job, list all full-time and part-time employment
Name of Firm Your Job Title Street Address Address Line 2 City State Start Date End Date Reason for leaving Beginning Salary Ending Salary
Describe your duties and responsibilities
Name of Firm Your Job Title Street Address Address Line 2 City State Start Date End Date Reason for leaving Beginning Salary Ending Salary
Describe your duties and responsibilities
Name of Firm Your Job Title Street Address Address Line 2 City State Start Date End Date Reason for leaving Beginning Salary Ending Salary
Describe your duties and responsibilities
Name of Firm Your Job Title Street Address Address Line 2 City State Start Date End Date Reason for leaving Beginning Salary Ending Salary
Describe your duties and responsibilities
Name of Firm Your Job Title Street Address Address Line 2 City State Start Date End Date Reason for leaving Beginning Salary Ending Salary
Describe your duties and responsibilities
Name of Firm Your Job Title Street Address Address Line 2 City State Start Date End Date Reason for leaving Beginning Salary Ending Salary
Describe your duties and responsibilities
Please include any other information you think would be helpful to us in considering you for employment, such as additional work experience, activities, accomplishments, special qualifications, etc. (You may exclude all information indicative of age, race, religion, color, national origin and handicap)
AGREEMENT (Please read the following statements carefully)

I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge; and agree that falsified information or significant omissions may disqualify me from further consideration for employment and may be considered justification for dismissal, if discovered at a later date.

I authorize persons, current employers (if applicable), and previous employers and organizations named in this application/resume (if any) to provide the Durham County ABC Board with any relevant information that may be required to arrive at an employment decision. I further authorize the Durham County ABC Board, its agents or appropriate law enforcement agencies to conduct an investigation of federal and/or state criminal and civil records. I understand that I must submit to a drug and substance abuse screening before any offer of employment is made.
Signature *

Clear
Date *

Month Day Year
Date
SKILLS
Graduate or Professional School if applicable
Semester Hours
Type of Degree/Major
List specific courses, workshops, training or rotations you have had that are related to the position for which you are applying.
Check the following skills, experiences, etc., which are applicable to you:

Driver's Licence Disbursements Tax Preparation Car for use at work Purchasing Accounting Typing Bank Teller Payroll Adding Machine Bookkeeper Sales Data Entry Foreign Language Cashier Sign Language Computer Hardware Statistical Analysis Braille Computer Software Budget Prep/Maintenance Work Planning/Coordination Contract Negotiations Employee Selection/Dismissal Employee Performance Evaluation Report Preparations Scheduling Staff Training Financial Reporting Work Assignment Oral Presentation Employee Counseling/Coaching Building/Construction
Indicate the type (e.g. professional, technical, clerical, service, etc.), and number of employees you have supervised.
List memberships in employment related professional or technical societies.
Do you currently work for the Durham County ABC Board? *

Yes No
Have you worked under any other name? *

Yes No
If YES, please indicate:
REFERENCES

Please provide 2-3 references that we may contact.

Reference Name

Years Known

Organization/Position

Home/Business Address/Phone

Ref #1

Ref #2

Ref #3

I attest under penalty of perjury, that I am legally authorized to work in the United States.
Applicant's Signature *

Clear
Date *

Month Day Year
Date
Business Phone

Area Code Phone Number
Should be Empty:

DURHAM COUNTY ABC BOARD

THE EMPLOYMENT PROCESS

EMPLOYMENT APPLICATION

PERSONAL DATA

Name

EMPLOYMENT HISTORY

SKILLS

REFERENCES