Hocking County 911 - Online Job Application

Hocking County 911 Employment Application

Please fill out this application as completely as possible.

Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the County Human Resources Department (located in the Auditor's office.)

* denotes required fields

Position(s) Applying For *

Today's Date *

(mm/dd/yyyy)

Last Name *
First Name *
Middle Name

Social Security Number *
xxx-xx-xxxx

Street Address *
City * , State * Zip Code *

Telephone *

Other Phone

Email Address

Have you ever been employed here before? *

Yes
No

If yes, give dates and positions:

Are you legally eligible for employment in this country? *

Yes
No

Date available to work

What is your desired salary range?

Type of employment desired

Full-Time
Part-Time
Temporary
Seasonal
Educational Co-Op

Are you able to meet the attendance requirements of the position? *

Yes
No

Have you ever plead "guilty" or "no contest" to, or been convicted of a crime? *

Yes
No

If yes, please give dates and details

Answering "Yes" to these questions does not constitute and automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

Drivers License Number

Drivers License State

(2 letter abbreviation)

Employment History (begin with most recent employer)

FROM TO	EMPLOYER	TELEPHONE #
STARTING JOB TITLE/FINAL JOB TITLE	ADDRESS
IMMEDIATE SUPERVISOR AND TITLE	SUMMARIZE THE NATURE OF WORK PERFORMED AND JOB RESPONSIBILITIES
MAY WE CONTACT FOR REFERENCE? Yes No Later
REASON FOR LEAVING	HOURLY RATE/SALARY START END

FROM TO	EMPLOYER	TELEPHONE #
STARTING JOB TITLE/FINAL JOB TITLE	ADDRESS
IMMEDIATE SUPERVISOR AND TITLE	SUMMARIZE THE NATURE OF WORK PERFORMED AND JOB RESPONSIBILITIES
MAY WE CONTACT FOR REFERENCE? Yes No Later
REASON FOR LEAVING	HOURLY RATE/SALARY START END

FROM TO	EMPLOYER	TELEPHONE #
STARTING JOB TITLE/FINAL JOB TITLE	ADDRESS
IMMEDIATE SUPERVISOR AND TITLE	SUMMARIZE THE NATURE OF WORK PERFORMED AND JOB RESPONSIBILITIES
MAY WE CONTACT FOR REFERENCE? Yes No Later
REASON FOR LEAVING	HOURLY RATE/SALARY START END

Skills and Qualifications - APCO Basic Telecommunicator Training Certification Required

Summarize any training, skills, licenses and/or certificates that may qualify you as being to perform job-related functions in the position for which you are applying.

Educational Background (if job related)

NAME AND LOCATION

NUMBER OF YEARS COMPLETED

DID YOU GRADUATE?

COURSE OF STUDY

HIGH SCHOOL

Yes
No

COLLEGE

MAJOR

DEGREE

OTHER

Yes
No

References

NAME

TELEPHONE

NUMBER OF YEARS KNOWN

Applicant Statement

I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.
I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately discharge me from the employer's service, whenever it is discovered.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that the employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, I am responsible for keeping my application current. Additionally, it may be necessary to reapply for employment.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and without prior notice, except as may be required by law. This application does not constitute and agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand that as a condition of employment, I will be required to submit to random drug testing.

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.

Signature of Applicant: *

Date: *

By typing your full name here, you acknowledge that your typed name represents your signed name (signature.)