Employment Application - City of Geneseo, Illinois

Application Information

Please complete the entire application

First Name

Middle Name

Last Name

Address

City

State/Province

Zip/Postal

Country

Email *

Telephone Number *

Are there other names under which you have worked or attended school? *

Yes

No

Other Name(s) which you have worked or attended school with

If you have worked or attended school with another name, please list for reference checking purposes.

Are you legally authorized to work in the U.S.? *

Yes

No

(If hired, you will be required to provide proof or work authorization)

Are you at least 18 years old? *

Yes

No

If not, your employment will be subject to verification that you meet state/federal minimum age requirements for the type of work you are applying for and having obtaining a valid work permit.

Have you applied with the City of Geneseo before? *

Yes

No

If yes, when:

If you have applied with the City of Geneseo before please list when.

Have you ever worked here before? *

Yes

No

If yes, when:

If you have worked for the City of Geneseo before please list when.

Position Applying For *

Employment Desired *

Full-Time

Part-Time

Salary Desired *

Shift Preference *

When are you available to start? *

City employees are required to live no more than 30 miles from City Hall within 6 months of employment. Some Electric and Public Works positions are required to live no more than 15 miles from City Hall within 6 months of employment, per the applicable collective bargaining agreement. If offered employment, are you willing to comply with these residency requirements? *

Yes

No

Special Skills / Abilities / Knowledge

Employment History

Start with most recent. Click ‘Add Employer’ to add an additional employer.

Past Employer

Name of Employer *

Telephone *

Address

City

State/Province

Zip/Postal

Country

Job Title *

List any relevant training programs completed. Click ‘Add’ to add additional training courses.

Course Details

Course / Seminar

Organization Sponsoring

Content

Date(s) Attended

Add Training Courses Remove

Employment References

List individuals familiar with your job qualifications (no family / relatives).

Name *

Day Telephone

Evening Telephone

Address

City

State/Province

Zip/Postal

Country

Relationship *

Your relationship to this reference

How long known? *

How long have you known this reference?

Name *

Day Telephone

Evening Telephone

Address

City

State/Province

Zip/Postal

Country

Relationship *

Your relationship to this reference

How long known? *

How long have you known this reference?

Name *

Day Telephone

Evening Telephone

Address

City

State/Province

Zip/Postal

Country

Relationship *

Your relationship to this reference

How long known? *

How long have you known this reference?

License(s)

To add additional license(s) click the ‘Add’ button.

License Details

Driver’s License Number

State Issued

Are you licensed with any group, association or society relating to the job for which you are applying?

Yes

No

Registration or License Number

Group, Association, or Society registration or license number

State Issued

Group, Association, or Society registration or license number issuing state.

Expiration Date

Date the License expires

Add License Remove

Where did you learn about this employment opportunity with the city?

All information contained in this application is true and correct to the best of my knowledge and belief. I understand that misrepresentations or omissions of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired.

I authorize the city to investigate my responses on this application and contact any or all of my former employers or any individuals familiar with me or my employment background for the purpose of verifying any information I have provided and/or for the purposes of obtaining any information, whether favorable or unfavorable, about me or my employment. I voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me or my employment. This report may contain information about me concerning my character, general reputation, personal characteristics, and mode of living, among other relevant things. This information may be obtained from a variety of sources, including but not limited to, government agencies, past employers, personal interviews with those who know me and others.

I understand that upon receiving a job offer, a criminal background check, a physical examination and drug screening may be requested. I also understand that upon employment, I must furnish proof of eligibility to live and work legally in the United States.

I also understand that the City will require me within six months of employment to reside within the residency standards applicable to the position. An employee’s failure to live within the boundaries of the residency requirements may constitute grounds for immediate dismissal.

Regardless of whether or not I become employed by the City, I recognize that this application is not and should not be considered a contract of employment. I understand that employment at the City is on an at-will basis and that my employment may be terminated with or without cause, and without notice, at any time, at my option or the company’s, unless specifically provided otherwise in a written employment contract. I further understand that no City employee or representative has the authority to enter into a contract regarding the duration of terms and conditions of employment other than an officer or official of the City, and then only by means of a signed, written document.

Signed by Applicant *

Type in your full name as your signature to accept the terms of application.

Date *

Date of Application, must be today’s date.

Attach Cover Letter

Maximum file size: 157.29MB

Attach Resume

Maximum file size: 157.29MB

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