Employment Application

Village of Algonquin

Application for Employment
We welcome you as an applicant for employment. Your application will be considered with others in competition for the position in which you are interested. All information contained in or connected with this application will be considered personal and confidential and used only in conjunction with your possible employment by the Village of Algonquin. Please furnish us with complete information in this application. Incomplete applications may not be considered. You are encouraged to attach a resume or any additional information that you believe qualifies you for the position for which you are applying.

The Village of Algonquin is an Equal Opportunity Employer. This prohibits discrimination because of race, color, religion, national origin, political affiliation, marital status, physical or mental handicap, sex, age or other protected categories, in all aspects of our personnel policies, programs, practices, and operations and applies to all phases of Village employment.
POSITION APPLIED FOR*

PERSONAL INFORMATION
LAST NAME*
FIRST NAME*
MIDDLE INITIAL*
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
HOW DID YOU HEAR ABOUT THE POSITION (i.e., Newspaper, Radio, College, Organization, etc.)?*

EDUCATIONAL INFORMATION
NAME & CITY OF HIGH SCHOOL*
DIPLOMA*

YESNO
HAVE YOU PASSED THE GED TEST?*

YESNON/A

COLLEGE/TECHNICAL SCHOOL INFORMATION

	NAME & CITY OF SCHOOL	NO. OF CREDITS	DEGREE	MAJOR
COLLEGE/UNIV
COLLEGE/UNIV
GRADUATE
TECHNICAL

SPECIAL QUALIFICATIONS
LIST ANY HONORS, PROFESSIONAL SOCIETIES/AFFILIATIONS, ACTIVITIES, SKILLS OR TRAINING RELATED TO THE POSITION FOR WHICH YOU ARE APPLYING (E.G. LICENSES, SKILLS WITH MACHINES, COMPUTER SKILLS, SPECIAL COURSES, TRAINING PROGRAMS, ETC.)
MILITARY SERVICE
BRANCH
DATES
TITLE
TYPE OF DISCHARGE

Did you have any employment history?

YesNo
EMPLOYMENT HISTORY

PLEASE LIST ALL EMPLOYMENT, STARTING WITH THE MOST RECENT.

OTHERWISE, IF NO OTHER EMPLOYMENT HISTORY CLICK NEXT.
1. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

Did you have an additional Employer?

YesNo
2. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

Did you have an additional Employer?

YesNo
3. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

Did you have an additional Employer?

YesNo
4. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

Did you have an additional Employer?

YesNo
5. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

Did you have an additional Employer?

YesNo
6. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

Did you have an additional Employer?

YesNo
7. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

Did you have an additional Employer?

YesNo
8. EMPLOYER
MAILING ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NO.
Please enter a valid phone number.
JOB TITLE/DUTIES PERFORMED
IMMEDIATE SUPERVISOR
EMPLOYMENT DATES
FULL-TIMEPART-TIME
REASON FOR LEAVING

MAY WE CONTACT YOUR PRESENT EMPLOYER?

YESNO
IF NO PLEASE EXPLAIN:*
IF HIRED, CAN YOU PROVE YOU ARE LEGALLY PERMITTED TO WORK IN THE UNITED STATES?*

YESNO
DO YOU SPEAK ANY LANGUAGES OTHER THAN ENGLISH?*

YESNO
PLEASE LIST THE LANGUAGES AND INDICATE YOUR LEVEL OF PROFICIENCY.*
ATTACH RESUME AND OTHER DOCUMENTS*

Cancelof

NOTICE TO APPLICANTS
(PLEASE READ BEFORE SUBMITTING THE APPLICATION)

I UNDERSTAND AND AGREE THAT ALL INFORMATION FURNISHED IN THIS APPLICATION MAY BE VERIFIED BY THE VILLAGE OF ALGONQUIN OR ITS AUTHORIZED REPRESENTATIVE. I WAIVE ANY RIGHT I MAY HAVE TO RECEIVE NOTIFICATION FROM ANY INDIVIDUALS AND ORGANIZATIONS NAMED OR REFERRED TO IN THIS APPLICATION PRIOR TO THE RELEASE OF ANY EMPLOYMENT INFORMATION TO THE VILLAGE OF ALGONQUIN. I HEREBY AUTHORIZE ALL INDIVIDUALS IN ORGANIZATIONS NAMED OR REFERRED TO IN THIS APPLICATION AND ANY LAW ENFORCEMENT ORGANIZATION, TO GIVE THE VILLAGE ALL INFORMATION RELATIVE TO SUCH VERIFICATION AND HEREBY RELEASE SUCH INDIVIDUALS, ORGANIZATIONS, AND THE VILLAGE OF ALGONQUIN FROM ANY AND ALL LIABILITY FOR ANY CLAIM OR DAMAGE RESULTING FROM THIS VERIFICATION PROCESS.

I CERTIFY THAT ALL FACTS CONTAINED IN THIS APPLICATION FOR EMPLOYMENT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT OMISSION OR MISREPRESENTATION OF FACTS MAY RESULT IN A REJECTION OF THIS APPLICATION, OR DISMISSAL FROM EMPLOYMENT IF SUBSEQUENTLY DISCOVERED. I UNDERSTAND AND AGREE THAT IF SELECTED AS AN EMPLOYEE, MY EMPLOYMENT WITH THE VILLAGE OF ALGONQUIN AND COMPENSATION CAN BE TERMINATED AT ANY TIME WITH OR WITHOUT NOTICE AND WITH OR WITHOUT CAUSE AT THE OPTION OF EITHER THE VILLAGE OR MYSELF (EXCEPT FOR EMPLOYEES SUBJECT TO A COLLECTIVE BARGAINING AGREEMENT). I FURTHER UNDERSTAND THAT NO DOCUMENT, INCLUDING BUT NOT LIMITED TO, THIS APPLICATION FOR EMPLOYMENT, A POLICY OR PROCEDURE MANUAL, OR A HANDBOOK, REPRESENTS AN EMPLOYMENT CONTRACT (EXCEPT FOR A COLLECTIVE BARGAINING AGREEMENT).
Date

MonthDayYear
SIGNATURE*

Clear
Should be Empty:

Village of Algonquin

PERSONAL INFORMATION

EDUCATIONAL INFORMATION

SPECIAL QUALIFICATIONS

MILITARY SERVICE