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Job Application

  1. CityLogo.jpg

  2. Referral Source:

  3. Type of employment desired*

  4. May we contact you at work?*

  5. If you are under 18 and it is required can you furnish a work permit?*

  6. Have you submitted an application before?*

  7. Are you legally eligible for employment in this country?*

  8. Will you travel if the job required it?*

  9. Are you able to meet the attendance requirements of the position?*

  10. Will you work overtime if required?*

  11. Have you ever been convicted of a crime?*

  12. Answering “yes” to these questions does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

  13. Starting with you most recent employer, assignments or volunteer activities, provide the following information.

  14. May we contact for a reference?*

  15. May we contact for a reference?*

  16. May we contact for a reference?*

  17. May we contact for a reference? *

  18. Skills

  19. Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve national guard or any other similarly protected status.

  20. Exclude memberships that would reveal race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/reserve national guard or any similarly protected status.

  21. I certify that all information I have provided in order to apply for and secure work with the employer is true, complete, and correct. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state, or federal law. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to reapply and fill out a new application. If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

  22. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (I) cancel further consideration of this application, or (II) immediately discharge me from the employer’s service, whenever it is discovered.

  23. All applications and resume submissions are subject to disclosure upon request under the Arkansas Freedom of Information Act.

  24. I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

  25. Leave This Blank:

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