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Please complete this form to apply for the position of: : Streets - Temporary Maintenance Worker, PW&P/Streets (168)

Please fill out all of the fields to aid in the process of your application.
Personal Information
First name Middle name Last name
Address line 1
Address line 2
City State Post code
Country
Daytime Phone
(example: 703-555-5555)		 Evening Phone
(example: 703-555-5555)
Mobile Phone
(example: 703-555-5555)		 Email address
(example: info@nerens.com)
If previously employed by Ogden City Corporation, show dates of employment.
Start: / End: /
Department:
Are you related to anyone presently employed by Ogden City?
No Yes - If Yes, who?
Have you ever been convicted of a felony?
No Yes
If yes, please explain.
Do you have a valid Utah Driver's License?
No Yes Expiration Date: /
Do you have a valid Commercial Driver's License?
No Yes Expiration Date: /
Are you legally able to work in the United States?
No Yes
Are you available to work shift work if the position you are applying for requires it?
No Yes
Are you a veteran of the United States Military Service?
No Yes - Branch: Dates:
Please fax official documents certifying honorable veteran's status 801-629-8735
Any comments:


Ogden City is an Equal Employment Opportunity Employer

To better help Ogden City Corporation meet our Equal Employment Opportunity/Affirmative Action Plan goals, we would appreciate your response to the information below. This form is for the Human Resources departmental use only and will be used for survey/reporting purposes only.
Gender:Date of birth
(date dd/mm/yyyy format)
Male Female - -
HispanicRace
No Yes

Educational Qualifications
You may fill all or none of the rows below; ensure that no fields are left empty per filled-in row
High School Graduate or Equivalent?
No Yes
Institute/University
(example: XYZ University)		 Degree
(example: Master's degree)		 Primary subject
(example: Accounting)		 Year
(example: 1992)

Employment History
You may fill all or none of the rows below; ensure that no fields are left empty per filled-in row

Begin with your most present or last employment and list in reverse order.
Give complete statement of every position you have had in the last 10 years.
Employer [1] Industry Starting Ending
/ /
Full Time Part Time Volunteer
Complete AddressPhoneJob Title
Responsibilities
SupervisorSupervisor Phone
Starting SalaryEnding Salary
Reason for leaving
 
Employer [2] Industry Starting Ending
/ /
Full Time Part Time Volunteer
Complete AddressPhoneJob Title
Responsibilities
SupervisorSupervisor Phone
Starting SalaryEnding Salary
Reason for leaving
 
Employer [3] Industry Starting Ending
/ /
Full Time Part Time Volunteer
Complete AddressPhoneJob Title
Responsibilities
SupervisorSupervisor Phone
Starting SalaryEnding Salary
Reason for leaving

Skills
You may fill all or none of the rows below; ensure that no fields are left empty per filled-in row
Computer / Typing Skills
No Yes - Net wpm:
Fax Certified Typing Test (if required for positions) to 801-629-8735
Second Language
No Yes  
Utah P.O.S.T. Certification
No Yes Type (Law Enforcement, Special Function, Corrections)
Certified P.O.S.T. Test is only for Law Enforcement positions.
Skill
 Experience
(example: 2 years)
year(s)
year(s)
year(s)

References
Give names, address and telephone number of three references, who are not related to you or a previous employeer.
Name
(example: Nerens)		 Phone
(example: 703-555-5555)		 Complete Address Occupation Years Known

Miscellaneous
Willing to relocate if necessary. How did you heard about us.
Browse for resume

OGDEN CITY IS AN EQUAL OPPORTUNITY EMPLOYER No person employed by Ogden City or seeking employment with the City shall be appointed, promoted, reduced, removed, or in any way favored or discriminated against because of political or religious opinion or affiliations, race, color, sex, national origin, or physical handicap. The submittal of this document via e-mail constitutes your acknowledgment that the information provided is true to the best of your knowledge. Any misrepresentations will be reason for dismissal.

I agree that any false statements in this application will be sufficient cause for rejection or dismissal. I hereby grant permission to investigate any of the statements in this application and to submit to a medical examination and drug test prior to employment. The use of this application does not indicate positions are open and does not obligate Ogden City in any way.


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