Reserves Application

Reserves Application

City of Durant, Oklahoma
The City of Durant does not discriminate on the basis of race, color, religion, sex, sexual orientatin, natinal origin, age, marital status, veteran status, political affiliation, handicap, handicap or disability status, or any other legally protected status. Applicants must be between the ages of 18 years (Fire Department) / 21 years (Police Department).
Date of Application:*

MonthDayYear
Date
Position Desired: *
Date available for work:*

MonthDayYear
Date
Social Security Number:*
Email Address*
example@example.com
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone:*
Please enter a valid phone number.
Business Phone:
Please enter a valid phone number.
Have you worked for the City before?*

YesNo
If yes, give prior name, dates, and reason for leaving:
Are you legally eligible to work in the United States? (Verification will be required upon employment and failure to furnish document will be cause for seperation.)

YesNo
Do you hold a current and valid drivers license?*

YesNo
If yes, list type, experation date, state and license number:
Are you related to any City Employees or any members of the City Council?*

YesNo
If yes, give name, department, and relationship:
Have you been convicted of a felony in the last 7 years or are you currently charged with the commission of a felony? (Note: this information does not in itself disqualify you for employment)*

YesNo
If yes, state what, when and how:
Military Service Branch:
Date Entered:

MonthDayYear
Date
Date and type of discharge:
Indicate specific military experience or training that is job related:
EDUCATION RECORD
Name and Address of Elementry School:*
Name and Address of High School:*
Name, Address, Course of study of College:*
Other (Please Specify):*
Did you graduate High School:*

YesNo
ADDITIONAL INFORMATION
Describe any specialized training, apprenticeship, skills and extra-curricular activities:
EMPLOYMENT EXPERIENCE
Resume Upload*

Cancelof
REFERENCES
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
ADDITIONAL INFORMATION
If you have any information or comments concerning any volunteer experience, and/or special certifications, licenses, or training that would help determine your suitability for this position, please attach additional sheets as necessary. All attachments must be signed.
Applicant's Agreement and Certification

Read Carefully Before Signing
The facrs set forth in my application for Reserve are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and financial, credit, and/or driving record through any investigation or credit agencies or bureaus of your choice.

In making this application for Reserve, I also understand that an investigation consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted. This inquiry, if made, may include information as to my character, general reputation, personal characteristics and mode of living. I understand that I have the right to make a written request within a reasonable period of time to recieve additional detailed information about the nature and scope of any such investigation report that is made.

The City of Durant has adopted a Drug and Alchohol Free Workplace policy, and in connection with such policy, the city required all applicants to undergo drug and alcohol screening following a conditional offer of employment, and such conditional offer is contingent on a negative test result from the pre-employment drug and/or alcohol screening. By signing below, I am acknowledging receipt of Notice of City's Drug and Alcohol Free Workplace Policy.

I also understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an at-will nature, which means that the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this at will employment relationship may not be changed by any written document or by conduct unless an authorized executive of this organization specifically acknowledges such change in writing. I understand that all applications will be kept on file with the City for period of one (1) year.
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty:

Reserves Application

EDUCATION RECORD

ADDITIONAL INFORMATION

EMPLOYMENT EXPERIENCE

REFERENCES

ADDITIONAL INFORMATION

Applicant's Agreement and Certification