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2. City of Olivette - Employment Application
4. The City of Olivette is an equal opportunity employer. All employment applications are reviewed based upon their qualifications, skills and abilities for the position, with or without accommodation. Every applicant is considered regardless of rac, color, religion, ancestry, gender, age, national origin, disability, military or veteran status, or any other protected status.
8. Position Seeking*
9. Date*
   Date
11. Full Name*
12. Email Address
14. Phone Number*
15. Alternate Number
17. Address
19. City
20. State
21. Zip Code
25. Are you legally eligible to work in the U.S.?*

    1. Yes

    1. No
26. Are you over the age of 18?*

    1. Yes
    2. No
28. To the best of your knowledge, are you able to perform the essential duties of the position, with or without accommodations?*

    1. Yes
    2. No
30. Are any of your relatives employed by the City of Olivette?*

    1. Yes
    2. No
31. If yes, please state your relative's name.
33. Upload resume.
34. Upload cover letter, license or certification(s).
38. EDUCATIONAL INFORMATION
40. Highest Education*

    1. Some High School
    2. High School/GED

    1. Some College

    1. College

    1. Post Graduate
42. High School/GED Name*
43. City/State*
47. College/University Attended
48. City/State
50. Major
51. Units completed
53. Unit Type

    1. Semester

    1. Quarter
54. Degree(s) completed
58. Trade/Business School Attended
59. City/State
61. Course of study completed
65. List any specialized training, certificates, licenses or skills.
69. WORK EXPERIENCE
71. Please list your employment for the past seven(7) years, with the most recent employment first. Please include all jobs within seven (7) years, and use summary area if necessary.
73. Employer 1 Name:*
74. Job Title:*
76. City
77. State
78. Zip Code
80. Start Date*
    Start Date
81. End Date
    End Date
82. Salary/Hourly Rate
83. Hourly/Annually

    1. Hourly
    2. Annually
85. Position Responsibilities
89. Employer 2 Name:
90. Job Title:
92. City
93. State
94. Zip Code
96. Start Date
    Start Date
97. End Date
    End Date
98. Salary/Hourly Rate
99. Hourly/Annually

    1. Hourly
    2. Annually
101. Position Responsibilities
105. Employer 3 Name:
106. Job Title:
108. City
109. State
110. Zip Code
112. Start Date
     Start Date
113. End Date
     End Date
114. Hourly/Salary Rate
115. Hourly/Annually

     1. Hourly
     2. Annually
119. Summary of other employment within last seven (7) years. Please include employer name, job title, and dates of employment.
123. PROFESSIONAL REFERENCES
125. Reference 1 Full Name*
126. Email Address
128. Employer
129. Phone Number*
131. Relationship
132. Years Known
136. Reference 2 Full Name*
137. Email Address
139. Employer
140. Phone Number*
142. Relationship
143. Years Known
147. Reference 3 Full Name
148. Email Address
150. Employer
151. Phone Number

     Phone Number

153. Relationship
154. Years Known
158. MILITARY SERVICE
160. Branch
161. Service Start Date
     Service Start Date
162. Service End Date
     Service End Date
164. Current Rank or Rank at Discharge
165. Type of Discharge
167. If not an honorable discharge, please explain.
171. DISCLAIMER AND SIGNATURE
173. 1. I certify that all statements are true and complete to the best of my knowledge. I authorize investigation of all information contained in this application.
     2. I authorize any person, organization or company listed on this application to furnish to the City of Olivette, any and all information concerning my previous employment, education and qualifications for employment, and hereby release any such person, organization or company from any liability that may result from furnishing such information.
     3. I understand that any falsification, misrepresentation or omission of facts called for herein will be sufficient cause for rejection of my application for employment.  In the event I am employed, I understand that I may be terminated from employment in the event of any falsification, misrepresentation or omission of facts called for herein.
     4. I understand any position I am offered may be contingent upon my passing a physical examination, drug/alcohol test and/or criminal background screening.  I authorize the City of Olivette to obtain a copy of my criminal record from any law enforcement agency for use in processing this application.
     5. I understand, based on the position I have applied for, I may be subject to additional testing/screening, including but not limited to a personality profile assessment.  I further understand that I may be subject to a credit check in compliance with the Fair Credit Reporting Act (FCRA) regulations, and that, if I am, I will be provided additional forms for this purpose. 
     6. I understand, if I am employed by the City of Olivette, that I will be required to provide verification of my identity and employment authorization to work in the U.S. I understand and agree to the information above.
175. Electronic Signature Agreement*

     By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

     1. I agree.
177. Electronic Signature*
178. Date*
     Date
Leave This Blank:


182. 1. Receive an email copy of this form.
183. Email address

     This field is not part of the form submission.

184. Submit Submit and Print

* indicates a required field