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Date Available to Work*
Do you have a legal right to work in the U.S. ?*
If yes, are you able to provide documents as required by law to verify your eligibility to work in the U.S.?*
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Do you have relatives working for the City of Kennedale or serving on the City Council?*
If so, provide the names of all relatives and their relationship to you.
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List your employment experience for the last ten (10) years, beginning with your current or last position and work back. Include military experience and account for periods during which you were unemployed.
Most Recent Employer
Start Date
End Date
Status
Employer
City
State
Phone Number
Position Title
Duties
Reason for leaving?
Supervisor Name
Supervisor Title
May we contact for reference?
Start Date
End Date
Status
Employer
City
State
Phone Number
Position Title
Duties
Reason for leaving?
Supervisor Name
Supervisor Title
May we contact for reference?
Start Date
End Date
Status
Employer
City
State
Phone Number
Position Title
Duties
Reason for leaving?
Supervisor Name
Supervisor Title
May we contact for reference?
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Have you been fired or asked to resign from any job within the past ten (10) Years?*
If yes please explain:
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Have you ever served in the U.S. Armed Forces? *
Service Start Date
Separation Date
Type of Discharge
List duties in the service, including special training that is relevant to the position for which you are applying:
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Professional Certifications and Licenses:
Office & Other Skills: Including supervision skills, other languages, additional training, technical skills or professional knowledge that would support your application: *
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I certify the statements made by me in this application are true, complete, and correct to the best of my knowledge, and are made by me in good faith. I understand that any falsifications, misrepresentations or omission of facts in this application may be cause for my elimination from consideration for hire, or, if already hired, cause for my dismissal, regardless of the time that elapses before such false information is discovered. I understand that, if chosen for employment, I must undergo a drug test, and I may be required to undergo a job-related physical requirements test, given at the City’s expense. I understand and agree that employees are “at-will” and employment with the City of Kennedale is for no definite period of time and that wages, benefits, and conditions of employment can be changed at any time. I understand that consideration of my employment in this position is contingent upon the result of a reference and background check.
I Agree*
Signiture*
By signing this form in the space provided above, I hereby swear and affirm that the information provided above is correct.
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