Plaza Associates Inc. Crabtree Valley Special Police Department. Application for Employment

Transcription

1 Plaza Associates Inc. Crabtree Valley Special Police Department Application for Employment INSTRUCTIONS: It is important that you fill out all section of this application completely and to the best of your ability. Your application will be used as part of the examination process and, therefore, should represent you best effort. PLEASE PRINT Current Information Position Applied For: Date: Available for Employment? Seeking: Time Time NAME ADDRESS TELEPHONE ( ) - Social Security Number: Driver License Number State Exp. Date General Information (Attach additional sheet if needed) 1. Have you ever been employed with Plaza Associates Inc.? Yes No If Yes, what department and when? 2. Apart from absences for religious observances, check conditions that you are willing to accept. Occasional: Nights Weekends Overtime Rotating Shifts On Call Regular: Nights Weekends Overtime Rotating Shifts On Call 3. Are you related by blood or marriage to any Plaza Associates Inc. employee? Yes No If yes, give name, department and relationship: 4. Are you a U.S. citizen? Yes No If no, you must be legally authorized to work in the U.S. and must provide work authorization documents before you begin work. 5. Have you EVER been convicted, under any name, of an offense against the law, other than a minor traffic violation? Offenses include, but are not limited to, driving while impaired, simple worthless check, and ANY misdemeanor or felony, even if resolved outside of court. A conviction does not mean you cannot be hired; the offense and how recently you were convicted will be evaluated in relation to the job for which you are applying. Yes No If yes, fully explain each, giving dates and details. Use additional sheets, if necessary, and sign and date each.

2 Education Give your complete education history below: High School Name: City: State: Have you received a high school diploma or equivalent? Yes No Highest Year Completed: Education Beyond High School Name and Location From Attend To Number Years Completed Degree or Diploma Year Received Major Subject Business College or University Graduate Professional, Other Skills and Certifications List any Professional Registration/Licenses/Certifications (Examples: CPA, EMT, etc.) List any training, classes or workshops you attended that are related to the position applied for: Extra-Curricular Activities/Volunteer Work: Typing/Word Processing WPM List office equipment you can operate: List Computer system/software programs you can use effectively: Employment History Record your complete work history in the spaces below. Begin with you current or most recent employer first. Attach sheets as necessary to account for your full record. Be sure to account for gaps in your employment history. Related volunteer experience should also be listed. Please explain any gaps in employment.

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4 5 6 If you are currently employed, may we contact this employer? Yes No Have you ever had disciplinary action taken against you in the past 12 months? Yes No If yes, explain under EXPLANATIONS (a yes will not automatically disqualify you) Have you ever been dismissed or forced to resign from any job held Yes No Were you dismissed or forced to resign for disciplinary reasons? Yes No If yes, to either question, explain under EXPLANATIONS (a yes will not automatically disqualify you) EXPLANATIONS References Name Address Telephone

5 Applicant Statement I certify that all of the information provided by me on this application or otherwise is accurate and complete. I understand that if I have knowingly misrepresented or falsified any of the application information, I may be disqualified for employment consideration or dismissed from employment with Plaza Associates Inc. I authorize my current and former employers to release any information regarding my employment along with any information regarding me, whether or not it is on their records. I hereby release them from any damage whatsoever for issuing same. I authorize educational institutions which I attended to reveal my scholastic rating as well as degrees or certificates earned, to Plaza Associates Inc. Notwithstanding any provision of State or Federal law, I expressly waive any right I have to review information that Plaza Associates Inc. receives from any employer or educational institution under a promise of confidentiality. I permit Plaza Associates Inc. to conduct a police, court, credit and/or motor vehicle records investigation of my background. I understand that upon offer of employment from Plaza Associates Inc., I will be tested for drug and alcohol use. I understand that nothing contained in the employment application or in the granting of an interview is intended to create an employment contract between Plaza Associates Inc. and myself for either employment or for the providing of any benefit. I understand and acknowledge that should Plaza Associates Inc. employ me, then I serve At Will. This means that I may be terminated at any time with or without cause. I further understand that this At Will employment relationship may not be changed by any written document or by conduct. I understand that if employed, policies and rules which are issued are not conditions of employment and that the employer may revise policies and procedures, in whole or in part, at any time. DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement Signature of Applicant: Date: State of North Carolina County of I,, a Notary Public for said County and State, do hereby certify that, Personally appeared before me this day and acknowledged the due execution of the foregoing statement. Witness my hand and official seal, this the day of, 20 Notary Public: My Commission Expires: