Welch Employment Application

Employment Application Form:

The City of Welch
88 Howard St.
Welch, WV 24801
304-436-3113

The City of Welch is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.
Personal Information:
Full Name*

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Birth Date

MonthDayYear
Are You a U.S. Citizen?

YesNo
Employment Desired:
Position Applying For
Date You Can Start

MonthDayYear
Salary Desired
Have You Worked Here Before?

YesNo
Have You Applied Here Before?

YesNo
Education:
High School
Name of High School Attended
Number of Years Attended
Graduated?

Yes
College
Name of College/University Attended
Number of Years Attended
Graduated?

Yes
Area of Study/Degree
Graduate School
Name of Graduate School Attended
Number of Years Attended
Graduated?

Yes
Area of Study/Degree
Trade School/Other
Name of Trade/Technical/Other School Attended
Number of Years Attended
Graduated?

Yes
Area of Study/Degree
Skills/Qualifications:
Skills
List any relevant skills
Certifications (Lifeguard/First Aid/CPR/AED/Water, Waste, Etc.
List any relevant certifications or qualifications
Certifications

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Veteran Information:
Branch of Service
Date of Entry
Date of Discharge
Part-time Active Duty Status?
Current Employment:
Current Employer
Name of Current Employer or NONE if not Employed
Position
Salary
Reason for Leaving?
Start Date

MonthDayYear
May We Contact?

YesNo
Previous Employment:
Previous Employer
Name of Previous Employer
Position
Salary
Reason for Leaving?
Start Date

MonthDayYear
End Date

MonthDayYear
Previous Employer
Name of Previous Employer
Position
Salary
Reason for Leaving?
Start Date

MonthDayYear
End Date

MonthDayYear
References:
Reference 1
Name of Reference
Relationship
Years Acquainted
Phone
Email
Reference 2
Name of Reference
Relationship
Years Acquainted
Phone
Email
Reference 3
Name of Reference
Relationship
Years Acquainted
Phone
Email
Cover Letter & Resume (Optional):
Resume

Upload a File

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Cover Letter

Upload a File

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Resume

Upload a File

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Send Application:
Signature

Clear
Date

MonthDayYear
Date
By clicking the submit button below, I cerity that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the City of Welch's rules and regulations, and I agree that my employment and compenstation can be terminated, with or without cause, and with or without notice, at any time, at either my or the City of Welch's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the City of Welch.
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Personal Information:

Employment Desired:

Education:

Skills/Qualifications:

Veteran Information:

Current Employment:

Previous Employment:

References:

Cover Letter & Resume (Optional):

Send Application: