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Personal Information

First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone Number*
Email Address*
Have you ever used another name?*
1. Yes
1. No
If yes, give name:
Other than minor traffic violations, have you ever been convicted of, pled guilty to, or currently have any charges pending against you for any offense, whether federal, state, county, or municipal?*
1. Yes
1. No
If yes to above question, describe in detail:
As used in this application, "convicted" includes any finding of guilty, plea of guilty, or plea of nolo contendere, regardless of whether or not imposition or execution of sentence is suspended. A traffic violation involving the use of alcohol or drugs is considered major, not minor. If you received a probation or any “non-conviction” disposition of a criminal charge, you must disclose it.
Yes *
I attest that I have read and understood the definition of convicted above and what is required to be disclosed on this application.
Are you at least 18 years old?*
1. Yes
1. No
If you are under the age of 18, and it is required, can you furnish a work permit?*
1. Yes
1. No
A previous applicant?*
1. Yes
1. No
A previous employee?*
1. Yes
1. No
Do you qualify for work study?
1. Yes
1. No
http://www.ucmo.edu/career/students/jobs/federalworkstudy.cfm
Do you have any relatives who work for the city?*
1. Yes
1. No
If yes to above question, provide names and relationships.
Are you eligible to work in the United States?*
1. Yes
1. No
A licensed driver with a car available for work?*
1. Yes
1. No
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Position Information

Education

Highest level of education obtained
1. Less than high school diploma or equivalent
2. High school
3. GED
4. Undergraduate
5. Graduate
6. Technical
7. Other
High School
Address
College/University
Address
Degree
Graduate/Professional School
Address
Degree
Technical/Business School
Address
Degree
Other School
Address
Degree
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Military Service

Have you ever served in the armed services of the United States or its allies?
1. Yes
1. No
If yes to above question, please provide the information below.
Branch of Service
Dates of Service
Rank at Discharge
Please attach a copy of your DD 214
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Other Training/Experience

Please describe any additional training/experience/skills you possess which would be an asset in performing the duties of this position:
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Licenses/Certificates Held

License/Certificate
Date Issued
License #
Licensing Authority
License/Certificates
Date Issued
License #
Licensing Authority
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Employment History

(From Most Recent)
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Salary
Reason for Leaving
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Salary
Reason for Leaving
Company
Position
Supervisor
Phone Number
May we contact your previous supervisor for a reference?
1. Yes
1. No
Address
Responsibilities
Employed From - To (Date)
Salary
Reason for Leaving
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References

Please list three professional references. References should be people who are unrelated to you who have knowledge of yur character and/or work history which would assist the City in evaluating you as a potential employee.
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
Full Name*
Relationship*
Company*
Phone Number*
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Disclaimer & Signature

I understand that the City of Warrensburg will be making inquiries to verify the information contained on this application, including contacting former employers and references and also verifying criminal, work, driving and educational records. I also agree to provide the necessary information to conduct this background check.

I hereby certify that I have carefully reviewed this application and that the information given in this application, and any accompanying documentation, is true, accurate and complete to the best of my knowledge and ability. I realize that, if employed, any false or misleading information given in this application and accompanying documentation may be grounds for dismissal. I further understand that this is an application for employment and that no employment contract is being offered. I understand that if I am employed, such employment is at-will and the City may change wages, benefits and conditions at any time.

I further certify that I have read the job description attached hereto and that I am able to perform the essential functions of the position, with or without and accommodation. I further consent to the full implementation of the City of Warrensburg, Missouri's, drug and alcohol testing policies as per the manual should I be placed for employment.

I understand that pre-employment drug testing is required before my employment with the City is final. I hereby consent to pre-employment drug testing.

I hereby authorize the City of Warrensburg, Missouri, to conduct inquiries into my character, reputation, and abilities and release those supplying such information from all liability. I further hereby authorize the City of Warrensburg, Missouri, to obtain a copy of my driving record and to perform a criminal records background check.

The City only accepts employment applications with original signatures.
Applicant Signature*
Date & Time
Date & Time
Date & Time
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Applicant's Self Assessment of Job Qualifications

Job Title*
Applicant's Name*
Instructions to Applicants

Attached is a description of the job for which you are applying. This job description does not list every job task or requirement, but it attempts to outline the tasks that a candidate must be able to perform to do the job, and the requirements that a qualified candidate should meet.

Please read this job description carefully. For each task, consider whether you can properly and safely carry out the task, and for each requirement consider whether you believe you can meet the requirement. If you have a disability, but can meet a requirement or do a task if we make a reasonable accommodation for the disability, answer "yes" when asked if you can do the job.
If you have questions about what the job requires, please contact Human Resources*
1. YES. I can meet all the job requirements and perform all the tasks of the job (with or without reasonable accommodation), with only the following exception(s):
2. NO. I cannot meet all the requirements of the job and perform all the essential functions, even with reasonable accommodation of any disabilities I may have.
Do you have any current openings that do not require:
Attestation

I have read the job description carefully. By signing here, I certify that, if I have said that I can do the job, I can perform all the essential functions of the job safely and properly, except as noted.
Signature
Date & Time
Date & Time
Date & Time

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GENERAL APPLICATION FOR EMPLOYMENT FIRE

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Personal Information

Position Information

Education

Military Service

Other Training/Experience

Licenses/Certificates Held

Employment History

References

Disclaimer & Signature

Applicant's Self Assessment of Job Qualifications

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