Employment Application Form

Employment Application

The City of Marietta is an equal opportunity employer.
Name

First NameLast Name
Phone Number:

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Address:
Are you 18 or older?
Are you eligible to work in the US?
Have you been convicted of a felony in the last seven years?
Explain felony conviction:
How were you referred to us?
Other:
Upload Resume:

Upload a File

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Job Interests, Skills & Training
Position applied for:
Salary requirement:
Type of employment requested:
Have you applied for a position here before?
Describe your skills:
Training or Certifications:
Do you have a high school diploma or GED?
Do you have a valid driver license issued by the state in which you reside?
Driver license number and type:
Professional References

Please list three (3) references that are familiar with your work life.
Reference 1
Full Name

First NameLast Name
Phone Number:

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years Known:
How do you know this person?
Reference 2
Full Name

First NameLast Name
Phone Number:

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years Known:
How do you know this person?
Reference 3
Full Name

First NameLast Name
Phone Number:

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years Known:
How do you know this person?
Military Service
Did you serve in the armed forces?
Branch:
Dates of service: Date to Date .
Type of discharge:
Employment History
Current Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor

First NameLast Name
Supervisor Contact

Area CodePhone Number
May we contact this employer?
Date of hire

MonthDayYear
Date
End of employment

MonthDayYear
Date
Beginning Salary:
Ending Salary:
Job Title:
Work Performed:
Previous Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor

First NameLast Name
Supervisor Contact

Area CodePhone Number
May we contact this employer?
Date of hire

MonthDayYear
Date
End of employment

MonthDayYear
Date
Beginning Salary:
Ending Salary:
Job Title:
Work Performed:
Previous Employer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Supervisor

First NameLast Name
Supervisor Contact

Area CodePhone Number
May we contact this employer?
Date of hire

MonthDayYear
Date
End of employment

MonthDayYear
Date
Beginning Salary:
Ending Salary:
Job Title:
Work Performed:
Acknowledgment

I certify that the answers given to me by this application are correct to the best of my knowledge. I understand that any falsification of this application, whether willingly or accidental, is grounds for disqualification of employment consideration, or dismissal from employment if I am hired. I authorize the City of Marietta to contact any and all of the references I have listed above to obtain previous employment information or any other pertinent information that they may have. Further, I release the above-mentioned references from any and all liability for any damages that may result from information collected by the City of Marietta. Verification of eligibility to work in the United States must be satisfied for an offer to be made.
Signature
Should be Empty: