City of Cordova Job Application Step 1 of 5 20% Position You're Applying ForPosition: Date of Application: Have you read the job description for the job for which you are applying? Yes No Do you meet the minimum qualifications for the position? Yes No Your Personal InformationYour Name First Last Your Email Address Enter Email Confirm Email Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Your PhoneBest Time To Call YouWhen is the best time for us to reach you via telephone?MorningsEarly AfternoonLate AfternoonEarly Evening General InfoHave you ever worked for the City of Cordova? Yes No Please provide the dates of employment: Are you currently on "lay-off" status and subject to recall? Yes No Do you have any family working for the City of Cordova? Yes No Do you have family currently serving on City Council Yes No Please list the names of the family members: If you are under 18, can you provide a work permit, if required? Yes No Are you legally eligible for employment in this country? Yes No Work Availability: Full Time Part Time Evenings Weekends Shiftwork Temporary/Seasonal Select AllOn what date would you be available to start work?(Required) If applying for a driving position, do you have a valid drivers license? Yes No Please provide the licensing state and number: Have you been convicted of a felony? Yes No If yes, please explain: EducationHighest Education Level AchievedElementary SchoolHigh School/GEDAssociates DegreeBachelors DegreeGraduate DegreeDegree/Diploma Describe course of study: Describe any specialized training, apprenticeship, skills and extra-curricular activitiesDescribe any honors you have received. State any additional information you feel may be helpful to us in considering your application.References:(Required)Please provide the name and telephone number of three business/work references who are not related to you and are not previous supervisors. Add Remove Previous EmploymentYour Previous EmployersPlease list your previous employers, the dates you worked, the position you held, and a good contact number for your supervisor.EmployerDatesPositionPhone Add RemoveUpload Your ResumeUpload your resume in .pdf, .doc or .docx formatAccepted file types: pdf, doc, docx, Max. file size: 25 MB.More About YouSpecial Skills and Qualifications:Summarize any special training, skills, licenses and/or certificates that may qualify you as being able to perform job related functions in the position for which you are applying. Terms and Conditions(Required)The information provided in this Application for Employment is true, correct, and complete. I understand that if employed, any misstatement, misrepresentation or omission of fact on this application may result in my dismissal. I give the City of Cordova the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy of the information provided in this application. If, as a pre-determined condition of employment, the City of Cordova requires a personal and/or credit background check, I acknowledge that I have been advised of this condition and with my signature, I authorize the City of Cordova to complete such a report. I further understand that if a report is obtained, I must be advised of such and that the City of Cordova, at my request, must provide me the reporting agency's contact information so I may obtain from them the nature and substance of the information contained in the report. The City of Cordova will not provide me with a copy of the report. I understand that if I am hired, I will be required to provide proof of identity and legal work authorization. I understand the City of Cordova's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA. I understand my acceptance of an employment offer does not create a contractual obligation upon the City to continue to employ me in the future. I agree to the terms and conditions. Δ
