• Application for Employment

    State of North Carolina
  • INSTRUCTIONS TO APPLICANTS

  • TO BE CONSIDERED FOR STATE EMPLOYMENT, YOU MUST ANSWER ALL QUESTIONS AND COMPLETE ALL SECTIONS OF THIS APPLICATION FORM.


    THE STATE EMPLOYS ONLY US CITIZENS OR ALIENS WHO CAN PROVIDE PROOF OF IDENTITY AND WORK AUTHORIZATION WITHIN 3 WORKING DAYS OF EMPLOYMENT MALES SUBJECT TO MILITARY SELECTIVE SERVICE REGISTRATION MUST CERTIFY COMPLIANCE TO BE ELIGIBLE FOR STATE EMPLOYMENT (G.S. 143B-421.1). SEE AVAILABILITY BLOCK.

  • WHEN COMPLETING THIS APPLICATION, PLEASE MAKE SURE YOU:

    • COMPLETE THE SECTION FOR EQUAL OPPORTUNITY INFORMATION.
    • APPLY FOR ONE VACANCY PER APPLICATION.
    • GIVE COMPLETE INFORMATION ON YOUR EDUCATION AND WORK HISTORY (“SEE RESUME” I S NOT ACCEPTABLE)
    • LIST SEPARATELY EACH JOB HELD AND YOUR DUTIES FOR EACH POSITION WHEN YOU WORKED FOR ONE EMPLOYER AND HELD MORE THAN ONE POSITION.
    • AS YOU DESCRIBE YOUR WORK HISTORY, MAKE SURE YOU HIGHLIGHT YOUR COMPETENCIES (KNOWLEDGE, SKILLS, ABILITIES AND WORK BEHAVIORS) WHICH DEMONSTRATE YOUR QUALIFICATIONS FOR THE POSITION FOR WHICH YOU ARE APPLYING.
    • PROVIDE ONLY THE LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER.
    • CHECK FOR ACCURACY, SIGN AND DATE YOUR APPLICATION.

     

    THANK YOU FOR YOUR INTEREST IN STATE GOVERNMENT. NORTH CAROLINA WANTS TO FIND THE BEST QUALIFIED PEOPLE AVAILABLE TO SERVE ITS CITIZENS. ALTHOUGH EVERYONE WHO APPLIES CANNOT BE HIRED, YOUR APPLICATION WILL BE GIVEN EVERY CONSIDERATION. 

    PD 107 (REV 10/2007)

  • Equal Opportunity Information

    State Government policy prohibits discrimination based on race, sex, color, creed, national origin, age or disability. Sex, age or absence of disability is a bona fide occupational qualification in a small number of State jobs. The information requested below will in no way affect you as an applicant. Its sole use will be to see how well our recruitment efforts are reaching all segments of the population.
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  • Personal Information

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  • Availability

  • If no, list the counties in which you would be willing to work:
    1.      2.      3.      
    4.      5.      

  • Military Service

  • Give dates of your (or spouse's) qualifying active military service:

  • Entered: Separated:
    Branch:    Rank:      

  • Education

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  • Current professional status: (list fields of work for which you have been registered) Registration: State: No:      
    Registration: State:  No:         

  • Skills

  • Work History

    (include volunteer experience) Use additional sections if necessary. As you describe your work history experiences, make sure you highlight your competencies which demonstrate your qualifications for the position for which you are applying.
  • Starting Salary: per .

  • Ending or Current Salary: per .

  • Additional Work History

  • Starting Salary: per .

  • Ending or Current Salary: per .

  • Additional Work History

  • Starting Salary: per .

  • Ending or Current Salary: per .

  • I certify that I have given true, accurate and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration and licensing boards, and others to furnish whatever detail is available concerning my qualifications. I authorize investigation of all statements made in this application and understand that false information or documentation, or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action or dismissal if I am employed, and (or) criminal action. I further understand that dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet position qualifications (Authority: G.S. 126-30, G.S. 14-122.1

    Unsigned applications will not be processed

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  • References

    List names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.
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  • Drug Screening Consent Through Urinalysis

  • I, *understand that as part of the preemployment process I am required to submit to a urinalysis drug screening. This is in accordance with the policy of McDowell County to maintain a workforce that is free of illegal drug abuse.

    I do hereby voluntarily consent to the sampling and submission for testing of my urine for the purpose of screening for the presence of illegal drugs and/or an abusive level of prescribed medication. I understand that a positive result from this screening may be a condition of employment and may bar me from employment with McDowell County for a period of one year.

    I authorize disclosure of the drug screen results by and between the testing
    laboratory, Medical Review Officer and the employing agency.

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  • Background Check Consent Form

    Wolfe Reality Check Consumer Report and Investigative Consumer Report Disclosure (For Employment Purposes)
  • Part 1 - Authorization for release of information (for employment purposes) 

    I hearby authorize Agency to receive information and disclose such information to its customers for the purpose of making a determination as to my eligibility for employment, promotion, retention or other lawful purpose. If hired or contracted, I authorize Agency and to retain this document on file to as as ongoing authorization for the procurement and possession of Reports at any time during my employment or contact period. I full release Agency and Suppliers from all claims of damages related to the investigation of my background and provision of information as set forth in this disclosure and authorization. I agree that information in Agency's possession may be supplied by Agency for legally permissible purposes; provided, such information will not include the Drug and Alcohol information set forth above, unless I have given a separated specific consent for Agency to share such information. 

    By signing below, I certify that: (i) all information provided herein is complete and accurate; (ii) I have read and fully understand this disclosure and authorization for release; (iii) prior to signing, I was given an opportunity to ask questions and to have those questions answered to my satisfaction; (iv) I execute the authorization voluntarily and with the knowledge that the informatio nobtained pursuant to this authorization could affect my eligibility for employment, promotion, retention or other lawful purpose; (v) I understand I may review this document with legal counsel prior to signing; (vi) I authorize Agency and any person or entity contacted by Agency to furnish the above mentioned information; and (vii) facsimile or photographic copies of this authorization are as valid as the original. 

     I understand that if I do not consent, any offer of my employment or contract will be withdrawn. If hired failure to cooperate with you or Agency regarding a current or future report will be cause to terminate my employment or contract. 

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  • Document Upload

    Please upload any necessary documents you would like provide alongside your completed Application for Employment. This may include resumes, transcripts, certifications, etc.
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