Municipality Job Application form

Application for Employment
Position Applying For
Full Name *

First Name Middle Initial Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Phone Number *

Area Code Phone Number
Available start date: *

Month Day Year
Do you have a valid driver's license? *

Yes No
Are you authorized to work and remain in the United States? *

Yes No
Were you ever discharged or forced to resign from any position? *

Yes No
If Yes, Explain:
Have you ever been employed by Lindon City? *

Yes No
Position:
Department:
Are you related to any employee of Lindon City? *

Yes No
Name of Employee:
Relationship:
Department:
Have you served in the U.S. Armed Forces? *

Yes No
If Yes, Branch:
Date Entered Active Duty:

Month Day Year
Date Released Active Duty:

Month Day Year
If Yes, Explain:
Education:
Are you a High School Graduate or Received High School Equivalency?

Yes No
Are you presently attending school?

Yes No
Type of Education
Name of Institution
Field of Study
Type of Degree
Did you Graduate?

Yes No
Do you have additional education to enter?

Yes No
Additional Type of Education
Name of Institution
Field of Study
Type of Degree
Did you Graduate?

Yes No
Professional License or Certificate, If Required
Type
Serial Number
Date Issued
Expiration Date

Month Day Year
Skills
Typing Words Per Minute:
10 Key Speed:
Word Processing:

Yes No
List Computer Background and Years of Experience:
Equipment Operated:
Employment History

Begin with your present or most recent work experience. A supplemental sheet or resume may be attached, but cannot be substituted for a completed application. Include military service if applicable.
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Supervisor:
Ending Salary Per Month:
Date Employment Started
Date Employment Ended
Reason for Leaving:
Description of Duties:
Do you have additional employers to enter?

Yes No
Name of Employer:
Job Title:
Phone Number

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Supervisor:
Ending Salary Per Month:
Date Employment Started
Date Employment Ended
Reason for Leaving:
Description of Duties:
Inquiry may be made of your current and former employers/schools you attended.
May we contact your present employer?

Yes No
May we contact your former employers?

Yes No
Personal References
Full Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Business or Occupation
Phone Number

Area Code Phone Number
APPLICANT’S STATEMENT

(Required for ALL Positions)

I understand that this employment application and any other city documents are not contracts of employment, and any person hired may be terminated by the employer at any time for any reason. I understand that any oral or written statements to the contrary are expressly disavowed and should not be relied upon by a prospective or existing employee. I understand that Lindon City may modify, change, or revoke any of its employment policies, pay practices, and benefits without my agreement. I hereby state that all answers on this application are true and understand that falsifying this information can lead to termination if hired.

I UNDERSTAND THAT IN ACCORDANCE WITH CITY POLICY, FINAL CANDIDATES ARE SUBJECT TO AN ALCOHOL / DRUG TEST AS A CONDITION OF EMPLOYMENT.

Writing in your name below constitutes acceptance of the above policy.
Full Name
Date

Month Day Year
Do you have any physical or mental disabilities which may limit your ability to perform essential functions of this job or which would require any special accommodations?

Yes No
If Yes, Please explain:
Upload Resume'
Upload Cover Letter
Should be Empty:

Application for Employment

Education:

Professional License or Certificate, If Required

Skills

Employment History

Personal References