Employment Application - City Of Robertsdale
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1
2City of Robertsdale
Employment Application
Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the
presence of a non-job-related medical condition or handicap. The City of Robertsdale is an equal opportunity employer.
Applicant Information
Full Name:
Date:
Last
First
M.I.
Address:
Street Address
Apartment/Unit #
City
State
ZIP Code
(
)
Phone:
E-mail Address:
Date Available:
Social Security No.:
Desired Salary:
$
Position Applied for:
Referred By:
YES
NO
YES
NO
Are you a citizen of the United States?
If no, are you authorized to work in the U.S.?
Have you ever worked for the City of
YES
NO
Robertsdale?
If so, when?
YES
NO
Have you ever been convicted of a crime?
If yes, explain: _______________________________________
NOTE: A criminal record does not constitute an automatic bar to employment and will be considered only as it relates to the job in question.
State name and relationship of any relatives employed with the City of Robertsdale:__________________________________
Do you have any physical, mental or medical impairment or disability that would limit your job performance? YES
NO
Education
High School:
Address:
YES
NO
Did you graduate?
Degree:
College:
Address:
YES
NO
Did you graduate?
Degree:
Other:
Address:
YES
NO
Did you graduate?
Degree:
Special training/skills/crafts:____________________________________________________________________________
Activities: (civic, athletic, etc.) __________________________________________________________________________
References
Full Name:
Relationship:
Company:
Phone:
(
)
Address:
Full Name:
Relationship:
Company:
Phone:
(
)
Address:
Full Name:
Relationship:
Company:
Phone:
(
)
Address:
__________________________________________________________________________________________
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Parent category: Business