Etowah County Application For Employment

Full Name

Date

Address

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number

Email

example@example.com

Are you seeking a position within the Etowah County Sheriff's Office?

Position Desired

Can you perform, with or without reasonable accommodation, the essential functions ofthe position for which you are applying?(If you have any questions as to what functions are applicable for the position for which you areapplying, please ask the interviewer before you answer this question

YesNo

If No, Please Explain:

When would you be available to start work?

Type of employment desired:

Full-TimePart-TimeTemporary

Are you eligible to be employed in the United States?

YesNo

Are you 18 or more years old? (Must be 19 or more to apply for Deputy Sheriff)

YesNo

Have you been convicted of a felony or misdemeanor which resulted in imprisonment within the last seven years? *A conviction will not necessarily result in the denial of employment.*

YesNo

If Yes, Please Explain:

Have you ever worked for Etowah County Before?

YesNo

If Yes, What Department:

Dates Employed - Beginning

Date

Dates Employed - Ending

Date

Do you have any friends or relatives who work for Etowah County?

YesNo

If Yes, Who:

Can you work any shift?

YesNo

Can you work overtime, including weekends?

YesNo

Have you ever been terminated from employment or asked to resign by an employer?

YesNo

If Yes, Please Explain:

High School

High School Diploma/GED Completion Year

1. College/Trade/Business

Year(s) Attended/Completed

Degree(s)/Certificate(s) Achieved (ex. Certificate, A.A.S., BS, MBA, etc.)

Study/Major

2. College/Trade/Business

Year(s) Attended/Completed

Degree(s)/Certificate(s) Achieved (ex. Certificate, A.A.S., BS, MBA, etc.)

Study/Major

3. College/Trade/Business

Year(s) Attended/Completed

Degree(s)/Certificate(s) Achieved (ex. Certificate, A.A.S., BS, MBA, etc.)

Study/Major

Academy Attended

Certification Number

Completion Date

Class

Expiration

Endorsements

Type of License

License Expiration

Other Professional Memberships/Certifications

List any special course seminar training or experience with equipment/tools that would enable you to perform the position for which you are applying

List honors, activities, offices held, etc. **You may omit any of the above which reflect your race, color, religion, age, sex, sexual orientation, marital status, or disabilities**

Upload any certificates, licenses, and/or degrees you wish to submit:

1. Employer Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Job Title

Supervisor

Dates Employed - Beginning

Dates Employed - Ending

Salary/Hourly Rate (Starting)

Salary/Hourly Rate (Ending)

Work Performed

Reason For Leaving

2. Employer Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Job Title

Supervisor

Dates Employed - Beginning

Dates Employed - Ending

Salary/Hourly Rate (Starting)

Salary/Hourly Rate (Ending)

Work Performed

Reason For Leaving

3. Employer Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Job Title

Supervisor

Dates Employed - Beginning

Dates Employed - Ending

Salary/Hourly Rate (Starting)

Salary/Hourly Rate (Ending)

Work Performed

Reason For Leaving

4. Employer Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Job Title

Supervisor

Dates Employed - Beginning

Dates Employed - Ending

Salary/Hourly Rate (Starting)

Salary/Hourly Rate (Ending)

Work Performed

Reason For Leaving

Please explain any gaps in work history:

May we contact your present employer?

YesNo

1. Name

Phone

Address

2. Name

Phone

Address

3. Name

Phone

Address

4. Name

Phone

Address

Applicant's Certification and Agreement

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I authorize Etowah County to verify their accuracy and to obtain reference information on my work performance.

I understand that, if employed, falsified statements of any kind, or omissions of facts called for on this application, shall be considered sufficient basis for dismissal. I understand that failure to reveal any prior employer, or giving false or misleading information by me on any part of this application for employment may be grounds for termination from Etowah County.

I understand that should an employment offer be extended to me and accepted, that I will fully adhere to the policies, rules and regulations of employment of Etowah County.

I further understand that neither the policies, rules, regulations of employment, or anything said during the interview process, shall be deemed to constitute the terms of an implied employment contract. I understand that any employment is for no definite time and "at will," and that either I or the County may terminate my employment at any time with or without notice or cause.

I attest with my signature below that I have given Etowah County true and complete information.

Signature of Applicant

Full Name:

Date

Etowah County

Etowah County Personnel Department 800 Forrest Ave, Gadsden, AL 35901

Education, Academy, Professional Degree(s):

Law Enforcement Academy:

Commercial Drivers License (CDL):

Professional Licenses, Certifications, or Memberships:

Employment History:

Professional References: