Employment Application Form

1. Written & Audio Tests: (Approximately 3 1/2 hours)

A. Includes testing in the following areas:

o Filing

o Spelling

o Comprehension

o Map Reading

o Dexterity

o Speed Writing

o Note Taking

2. Oral Board

3. Criminal history background check

4. Past employment history check

5. Reference check

6. Pre-employment drug screen

All areas above will be utilized in making a decision regarding an applicant’s potential for hire. Completing all steps in the process does not in and of itself constitute a job offer with Warren County Emergency Services.
Employment Application

Applicants are considered for all positions without regard to race, color, religion, sex, national origin, marital or veteran status, or the presence of a non-job related medical condition or handicap.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
Email
example@example.com
Social Security Number*
If employed, can you provide proof of receipt of a High School diploma or G.E.D equivalent?*

YESNO
If employed, can you provide proof that you are at least 21 years of age or older?*

YESNO
Have you previously been employed by this Organization?*

YESNO
Are you presently employed?*

YESNO
If YES to the above question, may we contact your present employer?*

YESNONot Presently Employed
Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status? (Proof of citizenship or immigration status is required upon request)*

YESNO
Have you been convicted of a felony?*

YESNO
If YES to the above question, please explain
If employed, what day would you be available to begin?

MonthDayYear
Date
EMPLOYMENT HISTORY

Give accurate, complete full time and part time employment history starting with your most recent employer. List all jobs held from the last 15 years and account for time unemployed.
Employer*
REFERENCES

List three (3) persons who are NOT related to you and have definite knowledge of your qualifications and skill for the position for which you are applying. (Recent graduate, please list instructors.)
Reference #1*
Reference #2*
Reference #3*
EDUCATION

Please list any education you would like to have considered for the position you are applying for. Attach additional sheets if necessary.
Education*
List any professional, trade, or service organizations in which you are a member, if you think such participation would be helpful to us in considering you for employment (e.g., organizing activities, additional work experience, accomplishments, leadership, etc.)
How were you referred to us?

Current EmployeeFacebookIndeedTwitterOther (please specify)
Resume and Files

Cancelof
Signature of Applicant*
Should be Empty:

Employment Application

EMPLOYMENT HISTORY

REFERENCES

EDUCATION