Departments Human Resources Application for Employment
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CITY OF TRINIDAD
EMPLOYMENT APPLICATION
 

 
INSTRUCTIONS
 

All applications for the City of Trinidad employment must be made on this form. This application form and its attachments are official property of the City of Trinidad and will not be returned. If more space is needed to give full answers or explanations attach additional pages. All information requested must be complete and accurate. A false, incomplete or misleading response may result in disqualification for employment.

 
Name: _____________________________   Social Security No.: ________________________
 
Mailing Address: ____________________      Town: ___________________________________
 
State: ______________________________   Zip Code: ________________________________
 

Telephone No.: ______________________    Driver's Lic. No./State: _____________________

CDL:   YES    Or    NO

 
APPLICANT=S CERTIFICATION
 

I certify that all information contained on this application is true and complete to the best of my knowledge and belief. I understand that the employment process may include drug screening, work fitness examination, medical and psychological exam, and review of driving record. I give the City of Trinidad and its authorized agents permission to verify any job-related information given in connection with this application. All new hire applicants will be required to show proof of citizenship. I understand, if employed, that the City of Trinidad can change wages, benefits and conditions at any time. I further understand that my employment can be terminated, with or without cause, at any time at the discretion of the City, or myself. I further understand that no management official, other than the City Council, has the authority to enter into an agreement contrary to the foregoing or make any oral assurance or promise of continued employment.

 
 

Applicant=s signature: _______________________________   Date: ______________________

 
 
City of Trinidad
212 Park Street
Trinidad, Texas 75163
903-778-2525
 
EQUAL OPPORTUNITY EMPLOYER
 

CITY OF TRINIDAD                                                                                                  EMPLOYMENT
212 PARK STREET                                                                                                      APPLICATION
TRINIDAD, TEXAS 75163
 

ANSWER ALL QUESTIONS - PLEASE PRINT

Applicants are considered for positions without regard to race, color, religion, sex, national origin, age, veteran status, or disability. The City of Trinidad may conduct preemployment qualification assessment testing. If you require accommodation for the testing process, you must notify Personnel when you submit your application.

 

Position applying for: ___________________________________________________________________________________

Applicants may be required to describe or demonstrate that they can perform job related functions.

 

Name: ________________________________________________________________________________________

(First)                                                     (Middle)                                 (Last)
 

Address: ______________________________________________________________________________________

(Number/Street)                                                         (City/Stat/Zip Code)
 
Telephone: _________________________________                      Social Security No.: ______________________________
 

Telephone number(s) you can be reached at when not at above number: _____________________________________

 
Driver=s License No.: ___________________________
 

Please check all hours that you are available to work:

 

full time ____        part-time ____   temporary ____    days _____    Evenings/nights ____   weekends ____   shifts _____

 

Date available to start work: _______________________________________________________________________

 

Have you ever filed an application here before: yes (   )   no (   )   If yes, give date: ____________________________

 

If you answer AYes@ to any of the following questions, please explain in full.

 

1.  Are you now working for or have ever worked for another water district or City? _________________________

     If yes, please explain: _________________________________________________________________________

 

2. Do you or does your spouse have any relatives presently working or holding office for the City of Trinidad?____

     If yes, please explain: _________________________________________________________________________ 

3. Are you on a lay-off and subject to recall? ______________ If yes, please explain: _________________________

 

4. Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?_____

     If yes, please explain: _________________________________________________________________________

     (If offered employment with the City of Trinidad you will be required within three (3) business days of beginning        employment to produce original legal documents that establish your identity and employment eligibility.)

 
5. Are you a veteran of the U.S. Military Service? ____Yes ____ No     If yes, Branch: ______________________
 
 

List any professional, trade, business or civic activities and offices held. (You may exclude any which indicate race, color, religion, sex or national original): 

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
 

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

1.     ________________________________________________________________________

2.      ________________________________________________________________________

3.      _______________________________________________________________________

 

Have you ever been bonded? __________    If yes, for which position(s): ___________________________________

Have you ever been convicted of a felony? _________  If yes, please list convictions: _________________________

 

SPECIAL QUALIFICATIONS OR SKILLS: List qualifications and skills you may possess which are required for the job as stated in the job announcement, such as typing speed, ability to operate specialized machinery or equipment, or professional registration or licensing. Indicate any training you have had which is directly related to the job for which you are applying: 

 ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________________________________________
 

 
 
EMPLOYMENT EXPERIENCE

List employers starting with the most recent. Include military service or volunteer work. Exclude organization names which indicate race, color, religion, sex, or national origin.

 
May we contact your present employer?    ______ Yes     ______ No
 

Employer: ____________________________________         Job Title: __________________________________

Street Address: ________________________________         City/State/Zip: _______________________________

Phone No.: ___________________________________          Supervisor: _________________________________

Beginning Employment Date: _____________________          Ending Employment Date: _____________________

Starting Hourly Rate/Salary: ______________________          Ending Hourly Rate/Salary: ____________________

Work Performed: _________________________________________________________________________Reason for leaving: ____________________________________________________

 

Employer: ____________________________________         Job Title: __________________________________

Street Address: ________________________________         City/State/Zip: ______________________________

Phone No.: ___________________________________          Supervisor: _________________________________

Beginning Employment Date: _____________________          Ending Employment Date: _____________________

Starting Hourly Rate/Salary: ______________________          Ending Hourly Rate/Salary: ____________________

Work Performed: _____________________________________________________________________________________________Reason for leaving: _____________________________________________________________________________

 

Employer: ____________________________________         Job Title: __________________________________

Street Address: ________________________________         City/State/Zip: ______________________________

Phone No.: ___________________________________          Supervisor: _________________________________

Beginning Employment Date: _____________________          Ending Employment Date: _____________________

Starting Hourly Rate/Salary: ______________________          Ending Hourly Rate/Salary: ____________________

Work Performed: _____________________________________________________________________________________________Reason for leaving: _____________________________________________________________________________

 

IF YOU NEED ADDITIONAL SPACE, PLEASE CONTINUE ON A SEPARATE SHEET OF PAPER.

 

EDUCATION

High School: ________________________________             Location: ___________________________________

Years Completed: (Circle)    9    10    11    12                Diploma: ______________________________

College or University: _____________________    Location: ______________________________

Years Completed: (Circle)    1    2    3    4                                 Degree: _______________________________

Graduate or Professional: ___________________ Location: ______________________________

Years Completed: (Circle)    1    2    3    4                                 Degree: _______________________________

Describe Course of Study:________________________________________________________________________

___________________________________________________________________________________

Honors Received: ______________________________________________________________________________

_____________________________________________________________________________________________

State any additional information you feel may be helpful to us in considering your application: __________________

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
 
APPLICANT=S STATEMENT
 

I CERTIFY THAT THE STATEMENTS CONTAINED HEREIN ARE TRUE, COMPLETE, AND CORRECT TO THE BEST OF MY KNOWLEDGE.

 

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that this application is not and is not intended to be a contract of employment.

 

In the event of employment, I understand that false or misleading information given in my application or interview (s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the City of Trinidad.

 
 
 
______________________________________                  __________________
Applicant=s signature                                                                          Date
 
 
 
 
 
 
 
 

APPLICANT INFORMATION
 
Please complete the following information. Your cooperation is appreciated.
 
PLEASE PRINT                                                                                                   DATE: ____________________
 

Position applied for: ___________________________________________________________________

 
Referral Source:            ______Advertisement                 ______Employment Agency

______Friend                             ______Received Notice in Mail

______Relative                           ______Walk-In

______Other (Specify) _________________________________

 

Name ______________________________________________________________________________

Last                              First                              Middle
 

Address: ____________________________________________________________________________

Number Street                                        City/State                      Zip Code
 
Telephone No.: ____________________________________
Area Code/Number
 

 

The City of Trinidad will automatically check your motor vehicle record if you are applying for any job opening which may involve the operation of a vehicle on public roads while conducting business for the City of Trinidad.

 

To expedite this process, please complete the following information:

 
_________________________________ ______________

Driver's License Number                         State

 
_________________________________ _______________________        ___________________

Last Name                                                         First Name                                Middle

 
 

The appropriate valid State of Texas driver's license is required to operate a vehicle on public roads while conducting business for the City of Trinidad. Failure to meet City guidelines will result in rejection of application.