Employment Application for the City of Lake Alfred

  • City of Lake Alfred Employment Application

  • PERSONAL INFORMATION:
    Personal and Background Information is used by the City of Lake Alfred in establishing your eligibility to work in the United States (via Federal I-9 form); in verifying your identity for various forms of background, credit, criminal activity, worker's compensation, medical history, and licensing checks; in furnishing information to various local, state, and federal agencies; in establishing social security deductions if necessary; and in setting up various means of compensation accounts, deferred compensation accounts, pension accounts, etc.

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  • BACKGROUND:

    The position you are applying for may require a drug testing, background screening or a valid Florida driver’s license of a particular class, with or without endorsements, and a safe driving record. Failure to state accurate information or falsification of any of the information requested herein may result in disqualification for employment consideration.

  • *Note: For the purposes of this question, “convicted” includes pleading guilty or nolo contendere, regardless of adjudication. A conviction is not necessarily a disqualifying factor; give all facts so that a decision can be made. This information will be verified.

    If you answered yes, to any of the questions above, please indicate the following:

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  • The City of Lake Alfred is an Equal Employment Opportunity Employer. No person shall, on the basis of race, color, creed, religion, sex, national origin, age, sexual orientation, marital status, gender identity, genetic information, handicap or disability, or veteran status, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity under the jurisdiction of the government of the City of Lake Alfred.

  • WORK HISTORY:

    Begin listing with present/last employer and list ALL employers for the past ten years. If necessary, use blank sheets and attach them to this form:
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  • Education

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  • REFERENCES

    Please list three (3) personal references (not related to you):

  • READ THIS APPLICATION AND YOUR ANSWERS CAREFULLY BEFORE SIGNING BELOW:


    I certify that to the best of my knowledge and belief all of the statements contained herein and on any attachments are true, correct, complete, and made in good faith. I am aware that any omissions, falsifications, misstatements, or misrepresentations above may disqualify me for employment consideration and, if I am hired, may be grounds for termination at a later date. I understand that any information that I give may be investigated as allowed by law through various sources, including but not limited to a Criminal History records search, Driver’s License history, credit check, former and current employers, and personal references. I consent to the release of information about my ability, employment history, and fitness for employment by employers, schools, law enforcement agencies, and other individuals and organizations to investigators, personnel staff, and other authorized employees of the City of Lake Alfred. This consent shall continue to be effective during my employment if I am hired. I understand that
    applications submitted for City employment are public records. If an offer of employment is made, I agree to submit to a pre-employment physical and drug test as a condition of such employment.

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  • Equal Employment Opportunity Statistic Survey

    Applicant, New Hire, or Employee Self-Identification Survey

  • I received, read, and understand the instructions and information provided with this voluntary survey.

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  • Anti-Discrimination Notice. It is an unlawful employment practice for an employer to fail or refuse to hire or discharge any individual or otherwise to discriminate against any individual with respect to that individual’s terms and conditions of employment because of such individual’s race, color, religion, sex, or national origin.

  • INVITATION TO SELF-IDENTIFY

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