Hazel Park Employment Application Form
Please complete all required fields and submit your application to the City Manager's Office.
Personal Information
Last Name
*
First Name
*
Middle Initial
Date
*
-
Month
-
Day
Year
Date
Position Applying For
*
Department
Current Mailing Address - Street
*
City
*
State
*
Zip Code
*
Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Michigan Driver's License #
*
Education
Education Record
Additional Education Record
Additional Education
Please list any additional training or education you may have had: military, apprenticeships, volunteering, etc.
Additional Education
Type of Education
Years Completed
Military Service
Have you ever served in the Armed Forces, National Guard, or Military Reserves?
*
Yes
No
Branch of Service
Dates of Service From
Dates of Service To
Honorable Discharge?
Yes
No
Licenses
Licenses (CPR, CDL, etc. ) If NONE leave blank
Experience
Begin with your present or last job. List a promotion as a new job.
Company Name
*
Salary
*
Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Supervisor
*
Address
*
City/State
*
Dates Employed
*
Full-Time or Part-Time
*
Full-Time
Part-Time
Hours Per Week
*
Job Title and Responsibilities
*
Reason for Leaving
*
May we contact your employer?
*
Yes
No
Company Name
Salary
Telephone
Please enter a valid phone number.
Format: (000) 000-0000.
Supervisor
Address
City/State
Dates Employed
Full-Time or Part-Time
Full-Time
Part-Time
Hours Per Week
Job Title and Responsibilities
Reason for Leaving
May we contact your current employer?
Yes
No
If no, please explain
Declaration of Applicant
Have you ever been employed by the City of Hazel Park?
*
Yes
No
If yes, date of employment
If yes, department
Do you have any relatives employed by the City of Hazel Park?
*
Yes
No
If so, position/department
If so, relationship
Are you a citizen of the United States?
*
Yes
No
Are you prevented from lawfully becoming employed in this country because of visa or immigration status?
*
Yes
No
References
Give the name of three persons not related to you who have knowledge of your experience and qualifications for the position.
Reference 1 - Full Name
*
Reference 1 - Address
Reference 1 - Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 1 - Years Acquainted
*
Reference 2 - Full Name
*
Reference 2 - Address
Reference 2 - Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 2 - Years Acquainted
*
Reference 3 - Full Name
*
Reference 3 - Address
Reference 3 - Telephone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Reference 3 - Years Acquainted
*
Authorization
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Submit
Should be Empty: