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City of Tavares Employment Application

2. 

3. City of Tavares Employment Application
   201 East Main Street, Tavares, FL 32778 Telephone (352) 742-6264 Job Line (352) 742-6450 Fax (352) 742-6351 Email: ApplyToday@Tavares.org An Equal Opportunity Employer and a Drug-Free Workplace. Applicants who need accommodation in with the Americans with Disabilities Act are ask to notify Human Resources.

   201 East Main Street, Tavares, FL 32778 Telephone (352) 742-6264 Job Line (352) 742-6450 Fax (352) 742-6351 Email: ApplyToday@Tavares.org An Equal Opportunity Employer and a Drug-Free Workplace. Applicants who need accommodation in with the Americans with Disabilities Act are ask to notify Human Resources.

5. Job ID*
   -- Select One --546547548

6. Position*
   -- Select One --Firefighter/ EMT or Paramedic (Medic preferred)Right-of-Way SpecialistPark Specialist 1

7. Posting Date*

9. First Name*

10. Last Name*

12. Address1*

14. City*

15. State*

16. Zip*

18. Phone Number*

19. E-Mail Address

23. Do you wish to claim Veteran's Preference?*

    1. Yes
    2. No

25. If, yes in order to be considered for Veteran's Preference you must submit a copy of your DD214 or other official document(s) from the Division of Veteran's Affairs which substantiates your eligibility for Veteran's Preference.

29. All applications and/or resumes must be submitted to Human Resources or postmarked by the advertised closing date, without exception. Applications and/or resumes are accepted only for positions that are posted and open for recruitment.

31. READ THIS SECTION CAREFULLY BEFORE YOU SIGN THE APPLICATION BELOW
    City of Tavares Human Resources staff or other designated City staff are authorized to verify any or all of the information contained herein. By my signature below, I hereby authorize the release of all information related to my application for employment, including, but not limited to, military service, education and employment history. A false answer to any question(s) in this application may be grounds for non-selection, or for termination after you begin work. All statements are subject to investigation, including a check of your training and experience statement. All information you give will be considered in reviewing your application. Your application may be subject to public inspection in accordance with the Florida Public Records Law, Chapter 119, Florida Statutes. I hereby certify that all statements made in this application and attached resume if included, are true. I understand that any misstatement, misrepresentation, material omission or falsification of facts shall cause forfeiture of all rights to employment with the City of Tavares. I understand that should I receive a conditional offer of employment, the following tests may be required as a condition of employment with the City of Tavares; drug screen, medical questionnaire, medical evaluation, employment background check, education background check, certification verification, worker’s compensation background check, motor vehicle records check, credit report, criminal history check, polygraph examination, psychological examination and a physical demonstration of job-related skills. If accepted for employment, I agree to abide by and comply with all rules, regulations, policies and practices of the City of Tavares. I understand that should I be hired by the City of Tavares, my employment with the City is at-will, that I have the right to terminate my employment at any time with or without cause, and that the City has the same right I understand that no representative of the employer has any authority to enter into any agreement with me contrary to the policies and practices of the City of Tavares.

    City of Tavares Human Resources staff or other designated City staff are authorized to verify any or all of the information contained herein. By my signature below, I hereby authorize the release of all information related to my application for employment, including, but not limited to, military service, education and employment history. A false answer to any question(s) in this application may be grounds for non-selection, or for termination after you begin work. All statements are subject to investigation, including a check of your training and experience statement. All information you give will be considered in reviewing your application. Your application may be subject to public inspection in accordance with the Florida Public Records Law, Chapter 119, Florida Statutes. I hereby certify that all statements made in this application and attached resume if included, are true. I understand that any misstatement, misrepresentation, material omission or falsification of facts shall cause forfeiture of all rights to employment with the City of Tavares. I understand that should I receive a conditional offer of employment, the following tests may be required as a condition of employment with the City of Tavares; drug screen, medical questionnaire, medical evaluation, employment background check, education background check, certification verification, worker’s compensation background check, motor vehicle records check, credit report, criminal history check, polygraph examination, psychological examination and a physical demonstration of job-related skills. If accepted for employment, I agree to abide by and comply with all rules, regulations, policies and practices of the City of Tavares. I understand that should I be hired by the City of Tavares, my employment with the City is at-will, that I have the right to terminate my employment at any time with or without cause, and that the City has the same right I understand that no representative of the employer has any authority to enter into any agreement with me contrary to the policies and practices of the City of Tavares.

33. Signature*

34. Date
    Date

38. Type of Employment Sought (check all that apply)*

    1. Full Time
    2. Part Time

39. Hours Available*

41. If job required, will you work:*

    1. Saturday
    2. Sunday
    3. Holidays
    4. Nights
    5. Various Shifts
    6. Other

42. Will you travel?

    1. Yes
    2. No

44. Date available for work/service*

46. Did you receive a High School Diploma?*

    1. Yes
    2. No

47. GED*

    1. Yes
    2. No

49. Universities or State College attended/attending

51. Type of degree received?

53. Indicate Major/Minor

55. *To receive consideration for college course work or Vocational Training, please provide quarter/semester or class hours earned in addition to dates attended. You may be required to submit college transcripts or list of courses successfully completed.

57. Business, Technical, Vocational Schools or Correspondence Courses ***attending/attended

59. Type of Degree or Program

60. Indicate Major/Minor

62. **If correspondence course, please identify as such.

64. Specific Skills: List the equipment with which you have had experience or any special skills you possess.

66. List the vehicles/equipment you can operate (if applicable to the job for which you are applying). You must also include this information in the Work History section on page 3.

68. List active licenses, certificates or registrations, the registration number(s) and expiration date(s). (If applicable to the job for which you are applying.)

70. How were you referred to the City of Tavares? (Please check the appropriate box.)

    1. Tavares.org (website)
    2. Relative
    3. Friend
    4. Employment Agency
    5. Walk-In
    6. Other

72. Other - Please Specify

74. Please list the name, address, telephone number and occupation of three (3) personal references who are not relatives or previous employers. *

78. WORK HISTORY - YOU MUST COMPLETE THE WORK HISTORY SECTION OF THIS APPLICATION
    List your most recent employer first. If currently unemployed, leave present employer section of this application blank. Include any unpaid work experience as well as military service. If you held more than one position with the same employer, list each separately. Please BE SPECIFIC. You must account for all periods of time for at least the last ten (10) years. If desired, include a resume or additional pages to clarify your work experience. If a resume is attached, be sure that month/year for each employment is reflected on the resume and coincides with the Work History section of this application.

    List your most recent employer first. If currently unemployed, leave present employer section of this application blank. Include any unpaid work experience as well as military service. If you held more than one position with the same employer, list each separately. Please BE SPECIFIC. You must account for all periods of time for at least the last ten (10) years. If desired, include a resume or additional pages to clarify your work experience. If a resume is attached, be sure that month/year for each employment is reflected on the resume and coincides with the Work History section of this application.

80. Present Employer*

81. Phone Number*

83. Address1*

85. City*

86. State*

87. Zip*

89. Job Title*

90. Supervisor*

92. Number Supervised

93. Last Salary*

95. From*

96. TO*

97. May we contact this employer?*

    1. Yes
    2. No

99. Reason for leaving?*

101. Responsibilities*

105. Past Employer

106. Phone Number

108. Address1

110. City

111. State

112. Zip

114. Job Title

115. Supervisor

117. Number Supervised

118. Last Salary

120. From

121. To

122. May we contact this employer?

     1. Yes
     2. No

124. Reason for leaving?

126. Responsibilities

130. Past Employer

131. Phone Number

133. Address1

135. City

136. State

137. Zip

139. Job Title

140. Supervisor

142. Number Supervised

143. Last Salary

145. From

146. To

147. May we contact this employer?

     1. Yes
     2. No

149. Reason for leaving?

151. Responsibilities

155. Past Employer

156. Phone Number

158. Address1

160. City

161. State

162. Zip

164. Job Title

165. Supervisor

167. Number Supervised

168. Last Salary

170. From

171. To

172. May we contact this employer?

     1. Yes
     2. No

174. Reason for leaving?

176. Responsibilites

180. MISCELLANEOUS
     Answer the following questions by checking (yes) or (no). It is imperative that you provide detailed information when requested, i.e., dates, types, etc., in the space provided at the bottom of the page.

     Answer the following questions by checking (yes) or (no). It is imperative that you provide detailed information when requested, i.e., dates, types, etc., in the space provided at the bottom of the page.

182. Are you able to perform the essential functions of the position with or without reasonable accommodation?*

     1. Yes
     2. No

184. If no, please explain:

186. Have you even been convicted of or plead guilty or no contest to any criminal violation of law?*

     1. Yes
     2. No

188. If yes, please explain. (A conviction does not automatically mean you are ineligible for hire. Please provide date(s), location(s), arresting agency(ies), charge(s) and disposition(s).)

190. Have you ever been discharged and or asked to resign from a job for any reason?*

     1. Yes
     2. No

192. If yes, please explain:

194. Have you ever been employed by the City of Tavares? *

     1. Yes
     2. No

196. If yes, indicate below, your previous date(s) of employment. Department(s)/Division(s), position(s) and reason for leaving.

198. Are any members of your family or relatives (by blood or marriage) employed by the City of Tavares?*

     1. Yes
     2. No

200. *If yes, indicate their name(s), Department(s)/Division(s), and relationship below.

202. Do you have the legal right to remain and work in the United States?*

     1. Yes
     2. No

204. Do you have a source of transportation to work?*

     1. Yes
     2. No

206. If no, explain how you will get to work below.

208. Do you possess a current, VALID Florida driver’s license?*

     1. Yes
     2. No

210. If yes, complete question below. If no, please explain.

212. Indicate which driver’s license you possess by checking the appropriate box:

     1. E (Regular Operator’s License)

214. Commercial Driver’s License (CDL) type:

     1. C
     2. B
     3. A

216. Do you have a driver’s license endorsement(s)? If yes, please check the appropriate box(es):

     1. H (Any vehicle used to transport hazardous materials in placard able amounts.)
     2. N (Tank vehicle designed to transport any liquid or gaseous material with designed capacity of 1,000 gallons or more)
     3. P (Any vehicle designed to transport 16 or more passengers, including the driver.)

218. Other:

220. If continuation of an answer, or additional comments applies.

222. Upload attachments (resume, DD214, etc.)

226. This form is for completion by applicants, and is used to collect information for reporting purposes only.

228. Qualified applicants are considered for employment, and employees are treated during employment, without regard to race, color, religion, sex, national origin or age. In keeping with that policy and to help us comply with federal and state Equal Employment Opportunity record keeping, reporting and legal requirements, please answer the questions below.

230. The information provided is confidential, and will be retained separately from your application for employment.

232. First Name*

233. Last Name*

235. Date of birth

236. Date of application

237. Sex

     1. Male
     2. Female

239. Vietnam Veteran

     1. Yes
     2. No

240. Disabled Veteran

     1. Yes
     2. No

242. Race/Ethnic Group

     1. Hispanic or Latino
     2. White
     3. Black or African American
     4. Asian
     5. Native Hawaiian or other Pacific Islander
     6. American Indian or Alaska Native
     7. Two or More Races

244. Signature*

245. Date
     Date

Leave This Blank:


247. 1. Receive an email copy of this form.
248. Email address

     This field is not part of the form submission.

249. Submit

* indicates a required field