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Application for Employment

  1. How did you learn about us?*

  2. GENERAL INFORMATION

  3. Do you have a valid driver's license?*

  4. If you are under 18 years of age, can you provide required proof of your elegibility to work?*

  5. Have you filed an application with us before?*

  6. Can you travel if the job requires it?*

  7. Have you been employed with us before?*

  8. Are any family or friends currently employed with us?*

  9. Are you currently employed?*

  10. May we contact your present employer?*

  11. Are you a veteran of the U.S. Military Service?*

  12. Are you currently on "lay-off" status and subject to recall?*

  13. Are you prevented from lawfully becoming employed in this country due to Visa or Immigration Status? *

    NOTE: Proof of citizenship or immigration status will be required upon employment.

  14. Are you available to work:

  15. EDUCATION & TRAINING

  16. Do you possess a high school deploma or GED?

  17. Degree Earned?

  18. Degree Earned?

  19. Degree Earned?

  20. EMPLOYMENT EXPERIENCE:

    Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which may indicate race, color, religion, gender, national origin, disabilities or other protected status.

  21. ADDITIONAL INFORMATION

    You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

  22. REFERENCES:

    Give name, address, daytime telephone number of three references who are not related to you and are not previous employers.

  23. Name, Address, Telephone & Email Address

  24. Name, Address, Telephone & Email Address

  25. Name, Address, Telephone & Email Address

  26. DRUG - FREE WORKPLACE ACT COMPLIANCE:

    The City of Fairfield complies with the Drug-Free Workplace Act. As a condition of our employment, you may be asked to participate in drug screening. If you refuse such screening or test positive (evidence of drug use) you will not be offered employment or such offer will be withdrawn.

  27. AMERICAN WITH DISABILITIES ACT COMPLIANCE:

    The City of Fairfield fully subscribes to the provisions of the American with Disabilities Act and will attempt in its employment process to make any reasonable accommodations necessary to assist qualified person with disabilities.

  28. "EQUAL OPPORTUNITY EMPLOYER"

  29. I understand that nothing in this application is intended to imply or create an employment relationship or contract for employment. I further understand that, if hired, my employment is at-will and can be terminated at any time, with or without notice, for any reason. I also understand that while personnel policies, programs, and procedures may of necessity change from time to time, such at-will status is not subject to change absent a written agreement signed by an authorized representative of the City of Fairfield.

  30. By inserting your name, you agree to the above statement.

  31. Attach cover letter and/or resume here.

  32. Leave This Blank:

  33. This field is not part of the form submission.