City of Franklin Application for Employment

City of Franklin Application for Employment

Qualified applicants are considered for all positions without regard to race, color, religion, gender, national origin, political affiliation, age, Veteran’s status, marital status or a non-job-related medical condition or disability.
Position Applied for:*
Date of Application*

MonthDayYear
Date
Contact Information
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone or Mobile Number*
Email Address*
example@example.com
Personal Information
If driving is required in the position you applied for - Driver's License Number:
Type N/A is not applicable
State/Province
Please check one:

Operator LicenseCommercial (CDL)ClassEndorsements
Date of Birth

MonthDayYear
Please provide the last four (4) of Social Security Number*
Are you at least 18 year old?*

YesNo
If you are under 18, can you furnish a work permit?*

YesNoN/A
If offered employment with the City of Franklin, can and will you provide documentation that you are legally authorized to work in the United States.*

YesNo
Do you have any relative(s) or person(s) living in the same household who is currently working in the same City department in which you are seeking employment?*

YesNo
Have you held previous employment with the City of Franklin?*

YesNo
If yes, provide dates worked and position held.
In the past five (5) years, have you been terminated or resigned in lieu of termination from a position?*

YesNo
For purposes of compliance with Section 2.2-2903 of the Code of Virginia, are you a veteran who has received an honorable discharge and has provided more than 180 consecutive days of full-time active duty in the armed forces of the United States or reserve components thereof, including the National Guard?*

YesNo
If yes, please specify the date discharged from armed services and type of discharge.
Have you ever been convicted or pled no contest in any court of law, of any criminal charge, felony or misdemeanor?*

YesNo
If yes, please explain the nature of the crime, date of the conviction, and state/country in which convicted. A conviction will not necessarily bar you from employment. You should not disclose any information regarding criminal records that have been sealed).
Are there any criminal or civil charges or proceedings pending against you?*

YesNo
If yes, please explain the nature of the crime, date of the conviction, and state/country in which convicted. A conviction will not necessarily bar you from employment. You should not disclose any information regarding criminal records that have been sealed).
Have you ever been convicted or pled no contest to a misdemeanor?*

YesNo
If yes, please provide a detailed explanation.
Additional Information
What is your highest level of education?*
What date would you be available to begin work?*

MonthDayYear
Date
Please provide your desired salary.*
Are you willing to relocate?*
Type N/A if not applicable
Education
School/University
School/University
School/University
Work Experience
Employer 1
Duties
Reason for Leaving
Employer 2:
Duties
Reason for Leaving
Employer 3
Duties
Reason for Leaving
Employer 4
Duties
Reason for Leaving
Employer 5
Duties
Reason for Leaving
Attach Resume and/or Cover Letter

Cancelof
Skills
Describe any special training, skills, licenses or certifications that may assist you in performing the position for which you are applying:
If you have computer skills, please indicate what skills you have and what software(s) you are proficient in the use of.
Describe any other job-related information that you would like the City to know about you.
References

Please list three (3) references that are familiar with your work life. At least one reference must be from a current/former supervisor. Please do not list relatives as references. Your references will be contacted through email and/or by telephone.
Reference*
Reference*
Reference*
How were you referred to us?
How did you hear about the position?*

Walk-InReferralNewspaper AdFacebookIndeedLinkedInOther (please specify)
By submitting this application I understand that I am acknowledging that I have read the description of job duties, essential functions, and qualifications required of the position for which I am applying*

YesNo
Should be Empty:

City of Franklin Application for Employment

Contact Information

Personal Information

Additional Information

Education

Work Experience

Skills

How were you referred to us?