Position Applying For *
Type of Work * I'm applying for regular, full-time workI'm applying for temporary/seasonal work
Days available to work
During what period of time will you be available?
Available for work on weekends? Yes, I am available to work weekends
Are you younger than 18 years of age? Yes, I am younger than 18 years old.
First Name *
Middle Initial
Last Name *
Address *
City *
State * AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip *
Address
City
State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Zip
Email address *
Phone Number *
Failure to complete this section may result in disqualification. A resume is not a substitute for completing the Employment History section. Substantial gaps in employment should be explained. List all jobs you have held in the past 10 years. PUT YOUR PRESENT OR MOST RECENT JOB FIRST. Include military service. By being thorough you may improve your chances for employment. If you need more space you may attach additional sheets. You must include number of hours worked each week.
From To
Total Years
Full Time or Part Time? Full TimePart Time
Employer's Name
Job Title and Duties
Employer's Address
Supervisor
Phone Number
Reason for Leaving
May we contact this employer for a reference? Yes, you may contact this employer.
Do you have a high school diploma or G.E.D? YesNo
Name of High School
Do you have an AA/AS degree? YesNo
Do you have a BA/BS degree? YesNo
Do you have a post graduate degree? YesNo
NOT high school
Name of institution
Course or major
Hours of units completed
Did you graduate? YesNo
Degree received
List Licenses or Professional Certifications/Registrations Relevant to This Position:
Type
Class
Number
Expiration Date
Has your license/certification ever been revoked or suspended? YesNo
If yes, state reason(s), date of revocation or suspension, and date of reinstatement.
Do you have a valid driver's license? YesNo A current DMV report showing an acceptable driving record will be required after job offer and prior to employment.
Do you have any relatives working for the District? YesNo
If yes, please identify: Name
Relationship
Department
If hired, can you present evidence of your U.S.citizenship or proof of your legal right to live and work in this country? YesNo
Have you been given a copy of the Job Description which outlines the essential functions of the job for which you are applying? YesNo
Are you able to perform the essential functions of the job which you are applying, either with our without reasonable accommodation? YesNo
If no, describe the functions that cannot be performed.
If you become a finalist for the position, do you have any objection to a representative of the District making inquiry of your present employer regarding your background and qualifications? YesNo
If yes, state the reason
If now employed, why do you want to leave?
Please provide in this space: 1) Any additional information you would like to have the District consider, 2) Any substantial gap in your employment history, and further explanation to any "yes" response
How did you hear about this job? NewspaperEmployerCraigslistFacebookInstagramNextDoorNTPUD Publication WebsiteZip Recruiter/Indeed/Jobs AvailableLinkedInOther (please specify)
Please specify
I HEREBY CERTIFY that the foregoing statements are true and accurate to the best of my knowledge and belief. I agree and understand that any misstatement of material fact contained in this application may cause me to forfeit all rights to employment with the District. Employment offer may be contingent on passing a job-related physical examination, drug test, and fingerprint background check.
Yes, I agree to these terms.
