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Online Application

Bradley County Human Resources

Position(s) Applied For:n(s) Applied For:
 Application Date:
Last Name:
 First Name:
 Middle Initial:
Address:
 City:
 State:
 Zip:
Telephone:
 Social Security Number:
 Drivers License No: *If App
Date Available For Work:
 Employment Type:
Full   Part   Temp   Seasonal   Co-op  
Were you previously employed by this organization? List any relatives or friends working for this organization:
Yes,     No
                   Date(s):
Department/Position:
Name:

 Relationship:

WORK EXPERIENCE
LIST PRESENT AND FORMER EMPLOYERS BEGINNING WITH MOST RECENT

From:
 To:
 Company Name and Address:
 Telephone:
Position Held:
 Describe Your Work:
Supervisor and Title:
Last Wages:
per
 

 Reason for Leaving:

 
From:
 To:
 Company Name and Address:
 Telephone:
Position Held:
 Describe Your Work:
Supervisor and Title:
Last Wages:
per
 

 Reason for Leaving:

 
From:
 To:
 Company Name and Address:
 Telephone:
Position Held:
 Describe Your Work:
Supervisor and Title:
Last Wages:
per
 

 Reason for Leaving:
 
From:
 To:
 Company Name and Address:
 Telephone:
Position Held:
 Describe Your Work:
Supervisor and Title:
Last Wages:
per
 

 Reason for Leaving:

 
May we contact the above employers? ze:10pt; font-family:arial,times;">
May we contact the above employers? Yes No Have you ever served an apprenticeship? No Yes
If "No", indicate which one(s) you do not wish us to contact.
If so, where?
  		  Dates:
 
Type of trade:

Special skills and qualifications - Mechanical and/or technical experience and abilities
relevant to the positoin for which you have applied

Specialized Skills (Check Skills/Equipment Operated)

 
Production Mobile Machinery (list) Other (list)
PC/MAC Spreadsheet
Terminal Shorthand
Typewriter WPM
Word Processing WPM

Education

 
Name Address Years Completed Did you Graduate Course of Study

High School
Yes
No

College
Yes
No 		Major
Degree
Other
Yes
No

References

 
Name Address Telephone Years Known

 
Name Address Telephone Years Known

 
Name Address Telephone Years Known

 
Name Address Telephone Years Known

 
Name Address Telephone Years Known


Miscellaneous Information

 
Have you been convicted of a crime, excluding misdemeanors and summary offenses, which has not been annulled, expunged, or sealed by a court? (A conviction record will not necessarily be a bar to employment.)

Yes   No

If "Yes" please explain and describe in full detail:

Can you verify your legal rights to work in the US by providing a birth certificate, proof of US Citizenship, or by some other means?

Yes   No

If you are under 18, are you able to furnish a work permit?

Yes   No

Are you able to perform the job(s) for which you are applying?

Yes   No

Applicant's Certification - Please read carefully before signing.

 
I certify that the answers given by me to the foregoing questions and the statements made by me in this application are correct and complete.
I understand that, if I become employed, a misrepresentation or omission of fact in this application may result in my discharge from employment.
I authorize the Company, as part of its evaluation of my suiability for employment, to contact all school officials, references, and my provious supervisors to secure information concerning my skills, character and ability.
I further acknowledge and agree that no manager or representative of the Company has any authority to enter into any employment agreement.
I understand and agree that, if I am employed, I will be an at-will employee and the Company may terminate my employment at any time and for any or no reason without prior notice.
You will be asked to sign the above. Do you agree to these terms? Yes No
Date:


I, am applying for a position with Bradley County Government. I understand that employment with certain departments, such as Juvenile Court, Juvenile Detention, Sheriff's Department, and EMS require a background check through the N.C.I.C., before I am considered for this position. I voluntarily give the following information and grant Bradley County Governemnt to complete a background check. I further understand that this information shall become part of my personnel file and remain confidential.

Full Name (Include Maiden Name)

Social Security Number

Date of Birth


I hereby submit this information to be reviewed by Bradley County Human Resources Personnel.



 


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