SC General Job Application Form

Job Application

Please complete the form below to apply for a position with us.
Position Applied For:*
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number*
Do you have a drivers license? (If required for the position for which you are applying)

YesNo
Have you ever been discharged or forced to resign from a job?*

YesNo
Were you previously employed by the City of South Charleston?*

YesNo
If yes, please explain.
Will you accept?*

Part time workFull time workShift workTemporary work
Military Service*

NoneYes
Branch
Rank
Serial Number
Date
Type of Discharge
Have you ever been convicted of a misdemeanor or felony?*

YesNo
Conviction is not a bar to employment. If so, what was it?
Are you legally authorized to work in the US on a full time basis?*

YesNo
Available Start Date

MonthDayYear
Is there anything which would prevent you from performing the essential functions of the job for which you are applying?*

YesNo
If yes, give details.

Education

	Name of School	Years Attended	Graduated?
High School
College
Graduate or Trade School
Other

What are your plans (if any) for improving your education?
Describe academic honors, awards, scholarships, etc.
Describe special skills or abilities.
Typing Speed
Dictation Speed
List memberships in professional organizations.
Employment History

List work experience, beginning with your present or most recent job. Describe each job separately. Give special attention to experience relating to the job you are applying for. Incomplete descriptions may result in a lower rating.
Employing Firm
Address
Your Title
Number Supervised
Supervisor
Duties
Date Employed
From: blanks toblank .
Full timePart time
Starting Salary
Last Salary
Reason for wanting to leave.
Additional Experience.
References

Do not list relatives or former employers.

	Name	Home Address	Phone	Years Known
1
2
3

Additional Information. Use this space for additional comments or explanations as necessary.
Upload Your Resume (optional)

Cancelof
I hereby certify that the answers given by me to the foregoing questions and statements made by me are true to the best of my knowledge. I understand that any false statement or misrepresentation of facts included in this application or supplements thereto is cause for rejection of my application or discharge after my employment.
Signature*

Clear
Date*

MonthDayYear
Date
I understand that I am applying for a position as an employee-at-will. I understand that, if hired, my employment will be for no definite period of time, that will be an employee-at-will, that I will be free to leave employment with the city at any time and for any reason and that the city may terminate my employment at any time with or without cause and with or without notice. I understand that nothing in the city's written policies, handbooks, or other documents may be construed as creating any contractual obligations on the part of the city. Furthermore, I understand that no one at the city is authorized to make any contract relating to my employment unless the contract is set forth in writing and signed by the mayor of the city.
I voluntarily authorize the city to obtain information from any employers or references listed.
I voluntarily authorize
to give information regarding me and I hereby release said persons from any liability or claim whatsoever for issuing this information.
Signature

Clear
Date

MonthDayYear
Date
I voluntarily authorize the city to obtain information from any employers or references listed.
I voluntarily authorize
to give information regarding me and I hereby release said persons from any liability or claim whatsoever for issuing this information.
Signature

Clear
Date

MonthDayYear
Date
I voluntarily authorize the city to obtain information from any employers or references listed.
I voluntarily authorize
to give information regarding me and I hereby release said persons from any liability or claim whatsoever for issuing this information.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Job Application

Employment History

References

I voluntarily authorize the city to obtain information from any employers or references listed.

to give information regarding me and I hereby release said persons from any liability or claim whatsoever for issuing this information.

I voluntarily authorize the city to obtain information from any employers or references listed.

to give information regarding me and I hereby release said persons from any liability or claim whatsoever for issuing this information.

I voluntarily authorize the city to obtain information from any employers or references listed.

to give information regarding me and I hereby release said persons from any liability or claim whatsoever for issuing this information.