Employment Application
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
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Phone Number
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Please enter a valid phone number.
Email
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example@example.com
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Position applied for
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Ex.: Water, Street, Parks, Any, etc
Social Security #
*
XXX-XX-XXXX
Date Available for Work
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Month
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Day
Year
Desired Salary
U.S. Citizen?
*
Please Select
Yes
No
List languages in which you are fluend
Ex.: English, Spanish, etc
Worked for the City of Carthage before?
Please Select
Yes
No
If yes, when
Have you ever been convicted of a felony?
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Please Select
Yes
No
If yes, explain
Driver's License #, State Issued, Type of License
Have you had any moving violations?
*
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Yes
No
If yes, explain
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EDUCATION:
*
High School - Address - Years Attended - College - Years Attended - Did you earn a degree? -
MILITARY SERVICE:
Branch - Dates - Rank at Discharge - Type of Discharge - If other than honorable, explain:
PREVIOUS EMPLOYMENT:
*
Company - Address - Phone - Supervisor - Job Title - Salary - Responsibilities - From/To - Reason for Leaving - May we contact your previous supervisor for reference?
PREVIOUS EMPLOYMENT:
Company - Address - Phone - Supervisor - Job Title - Salary - Responsibilities - From/To - Reason for Leaving - May we contact your previous supervisor for reference?
PREVIOUS EMPLOYMENT:
Company - Address - Phone - Supervisor - Job Title - Salary - Responsibilities - From/To - Reason for Leaving - May we contact your previous supervisor for reference?
REFERENCES:
Full Name - Company - Relationship - Address - Phone -
REFERENCES:
Full Name - Company - Relationship - Address - Phone -
REFERENCES:
Full Name - Company - Relationship - Address - Phone -
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Signature - I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
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Background Check Releasse
The City of Carthage obtains a criminal history background check for applicants applying for all positions. The computerized criminal history (CCH) verification check will be performed by accessing the Texas Department of Public Safety Secure Website and will be based on the name and date of birth identifiers supplied by the applicant. The City will not consider your application for employment if this Disclosure and Authorization form is not completed, signed and returned to the Human Resources Department along with your application for employment. By signing below, you give permission for the City of Carthage to obtain a criminal history background check.
Sign here for permission to perform a background check.
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Date of Birth
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