APPLICATION FOR EMPLOYMENT WITH ALLEN COUNTY An Equal Opportunity Employer
Please fill out the following employment application form completely and accurately. Please use a pen and print clearly or type.
Downloadable Word Document Form (When the document opens in a new window, click "File" and "Save As..." to save the application to your computer.)
* All Fields are Required
SECTION I - Personal Information
Name:
Street Address:
City:
State:
Zip Code:
Country:
Home Phone:
Work Phone: (Optional)
Are you at least 18 years old? Yes No
Are you a citizen of the United States? Yes No
If under 18, can you obtain a work permit? Yes No
Do you have any physical, mental or medical impairment that will interfere with your ability to perform the job for which you are applying? Yes No If yes, please explain:
Have you filed an application with Allen County before? Yes No If so, what Department:
Have you ever been employed with Allen County before? Yes No If so, what Department:
SECTION II -Work Preferences
Please describe in one or two sentences the nature of work in which you are interested:
Do you need: Full-time work Part-time work
What is your minimum salary requirement:
Date available to start:
SECTION III -Work Experience
Please describe your work experience over the last ten years by completing the spaces below. (Be sure to include United State military experience or prior public service work regardless of the number of years ago.) Begin with your most recent employer.
Describe your duties, responsibilities, equipment operated, etc. for positions(s) held:
Describe your reason(s) for leaving:
SECTION IV - Educational Experience and Training
Other (please describe):
Name and location of school(s) attended. Also please state your G.P.A. and degree type: 1.) 2.) 3.) 4.)
Please describe the courses you took or technical training you have received from school which you feel would help you perform the job for which you are applying: (include special machines or equipment you operate, hobbies, or volunteer work projects which have taught you qualifying skills, etc.)
SECTION V- Miscellaneous
Do you presently have or are you willing to obtain a valid State of Ohio Certified Driver's License? Yes No
Do you have a valid State of Ohio Commercial Driver's License? Yes No
I solemnly swear that all of the information furnished in this employment application is true, accurate and complete to the best of my knowledge. I understand that any misrepresentation or falsification of the information provided may lead to withdrawal of an employment offer or termination after employment.
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