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Submit a General Application

Please fill out the form below and click Submit to submit your application for consideration. Fields with an asterisk (*) are required.

Resume
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Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip:
* Phone:
* Email:
Attachments
Cover Letter:
You can type in a Cover Letter or Copy/Paste from an existing document.
Application for Employment
PERSONAL INFORMATION
Yes   No
Yes   No
Yes   No
Yes   No
EMPLOYMENT DESIRED
Full Time   Part Time   Seasonal
EDUCATION

Give record of all High Schools, Colleges, Universities and Vocational/Technical Schools you have attended.

School 1

*
*
*
Yes   No
*
*

School 2

Yes   No

School 3

Yes   No

School 4

Yes   No

School 5

Yes   No
EMPLOYMENT HISTORY

Please provide us the last ten years of your employment history.

Employer 1

*
*
*
*
*
*
*
*
*
Yes   No
*
*
*
*

Employer 2

Yes   No

Employer 3

Yes   No

Employer 4

Yes   No

Employer 5

Yes   No
REFERENCES

Please provide three references (not relatives).

Reference 1

Reference 2

Reference 3
AUTHORIZATION

The facts set forth in this application and any supplemental information are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand that I am required to abide by all rules and regulations of the company.

General Questions
How did you hear about this position?
Are you related to anyone who works for this office? If so, state name, department and location
* Are you able and willing to travel as needed for the job?
Yes
No
Please explain any gaps in your employment history.
* Have you received any written reprimands or disciplinary suspensions during any previous employment?
Yes
No
If Yes, please explain:
* Have you ever been discharged or asked to resign?
Yes
No
If Yes, please explain:
Is there any other job-related information you want us to know about you?
Background Check Information
* Do you have a valid driver's license
Yes
No
* What class of license do you possess?
* List driver's license number and state?
* Have you had a suspension or probation of your license within the last five (5) years?
Yes
No
* How many speeding or other moving violations have you received in the last three (3) years?

List below all traffic violations (except parking) on your record for the last five (5) years and all motor vehicle accidents in which you were involved.

Date / Location / Description / Result
Date / Location / Description / Result
Date / Location / Description / Result
* WITHIN THE PAST SEVEN (7) YEARS:
Have you ever been convicted of, or pled guilty, no contest or nolo contendere to a crime?
Yes
No
If Yes, give details (date, place, offense(s), disposition, etc.)
Military Record
* Were you in the U.S. Armed Forces?
Yes
No
If Yes, what Branch?
Did you receive any training in the U.S. Armed Forces that is relevant to this office?
Veterans' Preference
Complete this section ONLY if you are claiming Veteran's Preference.
Have you entered into covered employment by any employer since October 1, 1987?
Yes
No
If yes, give name of employer:
If you claim Veterans' Preference, choose the type below. Attached copies of the required documents to your application to support your claim.
1. Veteran of wartime era- Requires (A) DD214 or other document showing dates of service and type of discharge.
2. Disabled Veteran- Requires (A) and (B) letter of service connected disability from the V.A.
3. Veterans' Widow- Requires (A) and marriage and death certificates, and statement saying not remarried.
4. Disabled Veterans' Spouse- Requires (A) and (B), evidence of marriage to the veteran, a statement that the spouse is still married at the time of application, and proof that the disabled veteran cannot qualify for employment because of disability.
5. Permanently Disabled Veteran- Requires (A) indicting veteran is permanently disabled, or (A) and letter from V.A. indicting that the veteran is permanently disabled.
6. Receipt of any Armed Forces Expeditionary Medal- Requires (A) DD214.

Veterans' Preference documentation must be submitted at the time of initial application. If any preference-eligible applicant claiming Veterans' Preference for a vacant position is not selected for the position, they have the right to an investigation by the Division of Veterans' Affairs if a non-preference-eligible applicant is appointed to a position. In order to commence the investigation, the applicant must file a written complaint addressed to the Division of Veterans' Affairs, P.O. Box 1437, St. Petersburg , FL 33731. A complaint shall be filed within 21 das after notice of a hiring decision. If a notice of a hiring decision is not given, it is the responsibility of the veteran to contact the employer within two months of the application to determine if the position has been filled. For further information, contact the Department of Veterans' Affairs.

Veterans Preference applies to all positions except those described in Florida Statute 295.07(5)(b)


I agree that this form may be electronically signed and agree that my typed signature is the same as a handwritten signature for the purposes of validity, enforceability, and admissibility.
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