Job Application

Application for Employment

The City of Covington is an Equal Opportunity Employer. Applicable law prohibits discrimination in employment because of race, color, religion, sex, age, national origin, disability, veteran status, or citizenship status. Applicants are considered for employment without discrimination based on any characteristic protected by law. No question on this application is asked for the purpose of limiting or excluding any applicant from consideration of employment on any unlawful basis.

General Information

Job Title *

Date of Application *

Last Name *

First Name *

Middle Name *

Home Phone *

Cell Phone *

Present Address *

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City

State

Zip Code

Country

Previous Address *

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State

Zip Code

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Are you under 18 years of age? *

If under 18 years of age, provide your date of birth. *

If hired, can you furnish proof of age? *

If hired, when would you be available for work? *

Job applied for *

Requested earnings $ *

Earnings are by the *

Have you previously applied for employment with the City? *

If yes, when?
*

For what position?
*

Have you worked for the city before? *

From *

To *

What position(s) did you hold? *

Training / Experience / Other Qualifications

List your training, skills, experience, or other qualifications for the job you are applying for. *

The job for which you may be considered requires the job holder to have a valid driver's license. Do you have a valid driver's license? *

License Class/Type *

State *

Number *

Expiration Date *

Education

Elementary School Name *

Last Year Completed *

Graduated *

Diploma or Degree Earned *

High School Name *

Last Year Completed *

Graduated *

Diploma or Degree Earned *

College Name *

Last Year Completed *

Graduated *

Diploma or Degree Earned *

List major course of study if applicable to the job you are applying for. *

Military

Have you ever served in the U.S. Armed Forces? *

What branch of service? *

List duties and special training received in the service. *

From *

Starting Rank *

To *

Final Rank *

Are you now a member of The National Guard or an Active Reserve Unit? *

Employment Record

Present Employer

Employer's Name *

Address *

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City

State

Zip Code

Country

Employed From *

Employed To *

Wage/Salary $ *

Position(s) Held *

Name and Title of Supervisor *

Type of Business *

May we contact your present employer for a reference? *

Describe Your Duties *

Phone Number *

Please Provide Your Employment History, Beginning with Most Recent Former Employer

#1. Previous Employer's Name *

Address *

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City

State

Zip Code

Country

Type of Business *

May we contact your present employer for a reference? *

Employed From *

Employed To *

Wage/Salary $ *

Position(s) Held *

Name and Title of Supervisor *

Describe Your Duties *

Phone Number *

#2. Employer's Name *

Address *

Line 1

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City

State

Zip Code

Country

Type of Business *

May we contact your present employer for a reference? *

Employed From *

Employed To *

Salary/Wage $ *

Position(s) Held *

Name and Title of Supervisor *

Describe Your Duties *

Phone Number *

#3. Employer's Name *

Address *

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Line 2

City

State

Zip Code

Country

Type of Business *

May we contact your present employer for a reference? *

Employed From *

Employed To *

Salary/Wage $ *

Position(s) Held *

Name and Title of Supervisor *

Describe Your Duties *

Phone Number *

Do the above employers include all the work you have performed in the last five (5) years? *

Unemployed Records

Please identify and explain all periods of unemployment during the last five (5) years.

From *

To *

Reason(s) for periods of unemployment *

From *

To *

Reason(s) for periods of unemployment *

Are you currently on "lay-off" status and subject to recall? *

Additional Information

Have you been convicted of a crime? *

Note: Do not include convictions that have been annulled, erased, expunged, set aside, sealed by a court, or referred to a diversion program.

If yes, please explain *

Conviction is not an automatic bar to employment. All circumstances will be considered.

Are you authorized to work in the U.S.? *

Documentation proving legal right to work in the United States will be required upon hiring.

Have you ever been fired or asked to resign from a job because of violation of an employer's policy or procedure? *

If yes, please explain *

Have you ever been known by any other name(s) that the City may require to verify information regarding your application? *

If yes, identify name(s) *

Provide the following contact information for a person to be notified in the case of an emergency should you be employed.

Address *

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State

Zip Code

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References

Please give the names of three (3) references (who are not related to you and are not previous supervisors) who are familiar with you and your job skills.

Address *

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State

Zip Code

Country

Phone Number *

Address *

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State

Zip Code

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Phone Number *

Address *

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State

Zip Code

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Phone Number *

Are there any family, relatives, or persons with whom you are involved in a close personal relationship who are employed by the City? *

If yes, Name *

If yes, Relationship *

"Equal Opportunity Employer"

Submit

Application for Employment

General Information

Training / Experience / Other Qualifications

Education

Military

Employment Record

Unemployed Records

Additional Information

References

"Equal Opportunity Employer"

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