Application For Employment Alexander County, NC Instructions To Applicants: To be considered for employment with Alexander County, you must complete all sections of this application. Alexander County employs only U.S. citizens or aliens who can provide proof of identity and work authorization within three business days of employment. Males subject to military selective service registration must certify compliance. When completing this application, give complete information on your education and work history. “See Resume” is not acceptable. Check for accuracy, electronically sign and date your application. * INDICATES REQUIRED FIELDEQUAL OPPORTUNITY INFORMATIONLocal Government policy prohibits discrimination based on race, sex, color, creed, national origin, age, genetic information or disability. The information requested below will in no way affect you as an applicant, the sole use will be to see how well our recruitment efforts are reaching all segments of the population.Date of Birth GenderMaleFemaleETHNIC GROUP*White (non-Hispanic)Black (non-Hispanic)Hispanic (Mexican, Puerto Rican, Cuban, Central or South American, other Spanish origin)Asian (including Pacific Islander)American Indian (including Alaskan native)Check the types of work you will accept:* Full-time Part-time Seasonal Temporary Position Applied For:*Select the Position Applied ForHeavy Equipment Operator – Part TimeBuilding Code Enforcement OfficerAnimal Care Technician/Animal Control OfficerSocial Worker III I/ATelecommunicator - PTNBPlease indicate your referral source:MILITARY SERVICEIf subject to Military Selective Service registration Certify compliance by checking Have you served honorably in the Armed Forces of the United States?YesNoDo you wish to declare a service-connected disability?YesNoGive dates of your (or spouse’s) qualifying active military service: Entered Separated Branch of ServiceAir ForceArmyCoast GuardMarinesNavyHighest Rank AttainedAre you a member of the Military Reserves?YesNoBranchAir ForceArmyCoast GuardMarinesNavyRankAt the time of application, are you the surviving spouse or dependent of a deceased veteran who died from service-related reasons?YesNoPersonal DataLast Name*First Name*Middle Name*Address*(Street number and name)City*State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip*County*Phone*Format: (###)###-####Business PhoneFormat: (###)###-####Do you now work for Alexander County?*YesNoAre you related by blood or marriage to any person now working for Alexander County?*YesNoIf yes, give the name, relationship and department.Driver’s License NumberDriver's License State IssuedAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificLast 4 Digits of SS #EDUCATIONSelect highest grade completed:*Please choose...123456789101112GEDCollege - 1 yearCollege - 2 yearsCollege - 3 yearsCollege - 4 yearsGraduate School - 1 yearGraduate School - 2 yearsHigh SchoolName and LocationFrom: To: Did you graduate?YesNoCollege(s)/University(ies)Name and LocationFrom: To: Did you graduate?YesNoS/Q Hrs.Major/MinorType of Degree ReceivedGraduate or ProfessionalName and locationFrom: To: Did you graduate?YesNoS/Q Hrs.Major/MinorType of Degree ReceivedList training programs and seminars completed in the last five yearsIf the job(s) applied for calls for specific courses, indicate the courses taken and credits received:Current Professional Status: (List fields of work for which you have been registered)Registration:State:No:Registration:State:No:Membership in Professional, Honorary, or Technical Societies (list):ADDITIONAL SKILLS AND EXPERIENCEPlease check the following skills, experiences, etc., you have: Sign Language Legal Transcription Typing Foreign Language Medical Transcription Word Processing Braille Adding Machine/Calculator Other List other skillsIf you have typing experience, specify WPMIf you know a foreign language, please specifyWORK HISTORYCurrent or Previous EmployerEmployer AddressSupervisor's NameSupervisor's Telephone NumberMay We Contact EmployerYesNoJob TitleNumber Supervised by YouLength of EmploymentDate EmployedMonth/YearDate SeparatedMonth/YearReason for LeavingStarting SalaryEnding or Current SalaryList major duties in order of importance in the job:Previous EmployerEmployer AddressSupervisor's NameSupervisor's Telephone NumberMay We Contact EmployerYesNoJob TitleNumber Supervised by youLength of EmploymentDate EmployedMonth/YearDate SeparatedMonth/YearReason for LeavingStarting SalaryEnding SalaryList major duties in order of importance in the job:Previous EmployerEmployer AddressSupervisor's NameSupervisor's Telephone NumberMay We Contact EmployerYesNoJob TitleNumber Supervised by youLength of EmploymentDate EmployedMonth/YearDate SeparatedMonth/YearReason for LeavingStarting SalaryEnding SalaryList major duties in order of importance in the job:Previous EmployerEmployer AddressSupervisor's NameSupervisor's Telephone NumberMay We Contact EmployerYesNoJob TitleNumber Supervised by youLength of EmploymentDate EmployedMonth/YearDate SeparatedMonth/YearReason for LeavingStarting SalaryEnding SalaryList major duties in order of importance in the job:List at least three references*NamePhone Attach Cover Letter (optional)Accepted file types: pdf.Attach resume in pdf format only.Attach Resume (optional)Accepted file types: pdf.Attach resume in pdf format only.I certify that I have given true, accurate and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration and licensing boards, and others to furnish whatever detail is available concerning my qualifications. I authorize investigation of all statements made in this application and understand false information, documentation or a failure to disclose relevant information may be grounds for rejection of my application, disciplinary action or dismissal if I am employed, and (or) criminal action. I further understand dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet position qualifications.Digital Signature of Applicant* Date* Signature of Applicant This field only to be signed upon hire.